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Can near-infrared energy reach the brain for treatment of TBI? - Video abstract [78182]

Larry D. Morries, Theodore A. Henderson MD, PhD - 2015 (Video)
This research was done under the supervision of NASA and seems to be some of the most independent research comparing therapy laser parameters.
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This video was created to support their published research. The authors did research using several lasers and slices of a sheep’s brain to try and determine the best parameter for treating TBI (Traumatic Brain Injury) with a desired fluency of 0.9 to 15 joules/cm2 at a depth of 2 cm. They state that getting the energy through the skull is especially difficult so they test multiple options so test the transfer rate. They started out using a continuous output split 980/810nm system (the only company that makes that type of split system, 80% of the power at 980nm and 20% of the power at 810nm, is LiteCure with their LightForce series). The result was less than 1/2% of the energy reached a depth of 2cm. Then they switched to pulsing and got an increase in the energy transfer. When they switched to a 810nm-only 15 watt system with pulsing the transfer rate increased to 16% of the output energy reached the target depth.

 Here are some rough numbers to review the feasibility of using this system for treatment. If the duty cycle is 70%, the system will deliver 1.68 joules per second at a depth 2cm (15wattS*70%*16%). To get 5 joules/cm2 over 15 x 15 cm treatment area would require a total of 1125 joules at depth. This would take 23 minutes.

This research shows that only class 4 systems can delivery the level of power needed for this kind of therapy in a typical rushed doctor's office. A class 3b system with 1 watt would take 4 - 5 hours per treatment to get the same dosage.

The original research publication is titled " Treatments for traumatic brain injury with emphasis on transcranial near-infrared laser phototherapy"

 

video length: (9:18)


Original Source: https://www.youtube.com/watch?v=iZbP2IVekh0

Effect of autologous mesenchymal stem cells induced by low level laser therapy on cardiogenesis in the infarcted area following myocardial infarction in rats

Hana Tuby1, Tali Yaakobi1, Lidya Maltz1, Yaakov Delarea2, Orit Sagi-Assif2, Uri Oron1* - (Publication)
This study showed rats that were give a heart attach and then treated with the laser on their shins saw a 55% reduction in infarct size in the heart showing that the stem cells migrated released from the bone migrated to the heart.
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 1Department of Zoology, The George S. Wise Faculty of Life Sciences, Tel-Aviv University, Tel-Aviv, Israel

2Department of Cell Biology and Immunology, The George S. Wise Faculty of Life Sciences, Tel-Aviv University, Tel-Aviv, Israel

Email: *oronu@post.tau.ac.il

Received 27 May 2013; revised 29 June 2013; accepted 16 July 2013

ABSTRACT

In this study, we investigated the hypothesis that photo- biostimulation by low-energy laser therapy (LLLT) applied to the bone marrow (BM) of myocardial in- farcted rats may attenuate the scarring processes that follow myocardial infarction (MI). Wistar rats under- went experimental MI. LLLT (Ga-Al-As diode laser) was applied to the BM of the exposed tibia at differ- ent time intervals post-MI (4 hrs, 48 hrs and 5 days). Sham-operated infarcted rats served as control. In- farct size was significantly reduced (55%) in the la- ser-treated rats as compared to the control non-treat- ed rats, at 2 weeks post-MI. A significant 3-fold in- crease was observed in the density of desmin immu- nopositive stained cells 14 days post-MI in the infarc- ted area of the laser-treated rats as compared to the non-laser-treated controls. The electron microscopy from the control infarcted rat hearts revealed a typi- cal interphase area between the intact myocardium and the infarcted area, with conspicuous fibroblasts with collagen deposition dispersed among them. In rats that were laser treated (to BM), the interphase zone demonstrated cells with different intracellular struc- tures. There was also a significant increase in the per- centage of c-kit positive cells and macrophages in the circulating blood of the laser treated rats as compar- ed to control non treated ones. In the majority of the cells clusters of myofibrils anchored to well-developed Z-lines and structures resembling the morphological characteristics of mature intact cardiomyocytes were evident. In conclusion, LLLT to the BM of rats post- MI induces cardiogenesis mainly at the borders of the infarcted area in the heart.

Keywords: Low-Level Laser Therapy; Myocardial Infarction; Macrophage; Desmin; Ultrastructure; c-Kit Positive Cells

1. INTRODUCTION

Regenerative capacity and mitotic activity in the heart are confined mainly to the lower vertebrates [1]. Amputation of ~20% of the zebrafish’s ventricular myocardium re- sulted in full regeneration without scarring [2]. In am- phibians, heart injury was associated with increased cell proliferation of myocytes and enhanced regeneration [3]. The adult mammalian heart was traditionally considered to be a post-mitotic organ with terminally differentiated cardiac myocytes. However, this dogma has recently been challenged by several studies and reviews [4-8]. These studies have suggested that cardiac myocytes are replaced throughout the lifespan even in the human heart, and that myocytes can regenerate from resident cardiac progenitor cells (CPC) as well as from bone marrow (BM). Studies in human infarcted hearts have shown evidence of cytoki- nesis of cells in the heart and evidence of cardiac stem cells that are activated in response to ischemic injury. This growth response is attenuated in chronic heart fail- ure [9]. Some studies have reported that cardiac myocyt- es can be derived from BM; specifically, side population precursor cells following induction of myocardial infarc- tion (MI) by left anterior descending artery (LAD) liga- tion [10-12]. Contradicting these findings, other laborato- ries using genetic markers have reported that lineage ne- gative, c-kit+ BM cells did not differentiate into cardio- myocytes [13]. It was also suggested that BM-derived stem cells may stimulate the small population of stem cells in the ischemic heart to proliferate and differentiate to enhance cardiac repair post-MI [14]. In a recent study transient regenerative potential in the mouse heart was demonstrated during the neonatal period [15].

Low-level laser therapy (LLLT) has been found to modulate various biological processes [16,17], such as increasing mitochondrial respiration and ATP synthesis [18], facilitating wound healing and promoting the proc- ess of skeletal muscle regeneration and angiogenesis [19- 21]. In an experimental model of the infarcted heart in rats and dogs, it was demonstrated that LLLT application directly to the infarcted area in the heart at optimal power parameters significantly reduced scar tissue formation [22-24]. This phenomenon was partially attributed to a significant elevation in ATP content, heat shock proteins, vascular endothelial growth factor (VEGF), inducible ni- tric oxide (NO) synthase, and angiogenesis in the ischemic zone of the laser-irradiated rats, as compared to non- irradiated rats [25].

The effect of photobiostimulation on stem cells or pro- genitor cells has not been extensively studied. LLLT ap- plication to normal human neural progenitor cells signi- ficantly increases ATP production in these cells [26]. LLLT delivery to MSCs and cardiac stem cells in vitro caused a significant enhancement in their proliferation rate [27,28]. LLLT has also been shown to increase the proliferation rate of adipose-derived stem cells in vitro [29]. Recently, we demonstrated that LLLT application to autologous BM could induce mesenchymal stem cells (MSCs) in the BM to proliferate and cause their recruit- ment and specific homing in on the infarcted rat heart and not on other organs [30,31]. The laser treatment to the BM also caused a marked and statistically significant reduction of 79% in the scarring and ventricular dilata- tion followed MI as compared to infarcted non-laser- treated rats. The aim of the present study was to investi- gate the possibility that induction of stem cells in the BM of rats by LLLT could also affect cardiogenesis in the in- farcted rat heart.

2. MATERIALS AND METHODS

2.1. Experimental Procedures

A total of 21 Wistar male rats, weighing 200 - 250 gr, that underwent ligation of the LAD artery to induce MI, were used as described by us previously [23]. All the ex- perimental procedures were approved by the animal care committee of Tel-Aviv University. Briefly, rats were anes- thetized with Avertin (1 ml/100 g body weight I.P.) and the lungs were ventilated. Thoractomy was performed by invasion of the intercostals muscles between the 5th and 6th rib to expose the heart. The LAD artery was occluded 2 mm from the origin with 5-0 polypropylene thread (Ethicon Inc., Cincinnati, OH). Following LAD artery occlusion the chest muscles and skin were sutured and the rats were ventilated until they woke up. The infarcted rats were divided randomly into two groups. In one group LLLT was applied directly to the BM 4 hrs, 48 hrs and 5 days post-MI (see below). The second group was non-laser-treated (the rat’s bone was exposed for the same duration as the laser-treated group but the laser was not turned on). Food and water were supplied ad libitum. Rats were sacrificed 14 days post-MI.

2.2. Laser Application

After induction of MI rats were randomly assigned to a laser-treated or control non-laser-treated group. A diode (Ga-Al-As) laser, wavelength 804 nm with a tunable po- wer output of maximum of 400 mW (Lasotronic Inc., Zug, Switzerland) for application to the BM was used. The laser device was equipped with a metal-backed glass fiber optic (1.5 mm diameter). An infrared viewer (Laso- tronic Inc. Zug, Switzerland) and infrared-sensitive de-tecting card (Newport, Inc., Irvine, CA) were used to de- termine the infrared irradiation area. Laser application was done by a 10 mm longitudinal cut in the skin above the medial aspect, and further delicate cleaning of the bone surface was carried out. The tip of the fiber optic (1.5 mm diameter) was placed perpendicularly to the center of the exposed medial aspect of the tibia and power den- sity of 10 mW/cm2 was applied to the BM. The laser was applied for a duration of 100 sec (energy density 1.0 J/cm2). Left or right exposed tibias were chosen at random for LLLT application. In sham-operated infarcted rats that served as control the tibias were exposed and the fi- ber optic was placed as described above but the laser beam was not turned on.

2.3. Histology and Electron Microscopy

A defined cross-section sample (2 mm thick) from the central part of the infarcted area was taken from all hearts for histology. Eight micron paraffin sections were pre- pared from the tissue samples of each heart. Infarct size was determined using Masson’s trichrome staining as described by us previously [23]. Three observers, blinded to control or laser-treated rats, analyzed infarct size. Six microscopic slides from the infarcted area of each heart were chosen at random for determination of infarct size. Infarct size was expressed as the percentage of the total infarcted area relative to the total area of the left ventri- cle (LV) in each section, using image analysis software Sigma Scan Pro (Sigma, St. Louis, MO).

For electron microscopy three tissue samples from each of the control and laser-irradiated rat hearts were taken from the interphase zone between the infarcted and non-infarcted tissue by macroscopic examination. Fixa- tion was performed in 3.5% glutaraldehyde in 0.1 M ca- codylate buffer for 24 hrs followed by embedment in Epon-812. Semi-thin sections (1 micron) were prepared in order to localize the interphase zone. Thin sections were then prepared and stained with uranyl acetate and lead citrate followed by examination with a Jeol electron microscope.

2.4. Immunohistochemistry

The total number of cells immunostained for desmin (bone marrow cells or newly formed) in the infarcted area were determined using a desmin kit (Zytomed Laboratory, Ber- lin, Germany). The procedure was performed at room temperature with anti-mouse (dilution 1:25 - 1:50) primary antibody for 60 min. Following washing, slides were in- cubated with HRP secondary antibody for mouse for 30 min followed by DAB Chromogen system (Covance Inc., Dedham). Slides were rinsed again in wash buffer, stain- ed in Hematoxylin for nuclei detection, mounted and viewed using a Zeiss microscope equipped with a camera and video screen. The total number of desmin immuno- stained cells within the infarcted area was counted and their density expressed as the percentage of the total area of the infarct using SigmaPro software.

2.5. Flow Cytometry Analysis

Blood samples were taken 2 and 7 days post-IR injury for fluorescence-activated cell sorting (FACS) analysis. 100 μl of blood were mixed with different antibodies: anti-mouse CD117 (c-kit) PE (eBioscience San Diego, USA) and rat IgG2b isotype control PE (eBioscience San Diego, USA) and anti-rat macrophage marker PE (eBio- science San Diego, USA) and mouse IgG2a K isotype control PE (eBioscience San Diego, USA), were used for the FACS analysis according to the manufacturer’s guide- lines. Forty five min post incubation of the whole fresh blood with the relevant antibodies, 2 ml of Fix/Lyse so- lution (eBioscience, San Diego, USA) was added. After mixture the suspended cells were left for 60 min in the dark at room temperature. Centrifugation was performed for 10 min, supernatant was removed and washing of the pellet was performed with 2 ml of Flow Cytometry Stain- ing Buffer Solution (eBioscience, San Diego, California, USA). After another centrifugation for 10 minutes the supernatant was decanted. The pellet containing mono- nucleated cells was resuspended in 200 μl of flow stain buffer for FACS analysis.

2.6. Statistical Analysis

The SigmaStat 2.0 (Sigma, St. Luis, USA) software was used for statistical analysis. Tests were performed first for normality distribution, followed by parametric (stu- dent’s t-test) test.

3. RESULTS

Application of LLLT to the infarcted heart caused a sig- nificant (p = 0.049) reduction of 55% in infarct size as compared to control. The present of macrophages and c- kit positive cells in the blood was determined by FACS analysis (Figure 1). It was found that at 5 days post MI there was a statistical significant 2-fold higher concentra- tion of macrophages and significant 1.4-fold higher c-kit positive cells (mesenchymal cells) in the laser treated rats as compared to the infarcted non laser treated rats. Des- min immunostaining of histological sections of the in- farcted zone from laser-treated rats demonstrated a higher density of positively stained cells than in the non laser-treated ones (Figures 2-4). In the interphase zone, cells extending from the myocardium towards the in 

Figure 1. Percent (out of total mononucleated cells) of macro- phages and c-kit positive cells in blood of control and laser treated rats (to the bone marrow) 5 days post MI as revealed by FACS analysis. The results are mean ± S.E.M of 15 rats at each group. Statistical significance *p < 0.05; **p < 0.01.

Figure 2. Representative desmin immunostained light micro- graphs of the infarcted zone of non-laser-treated rats (a, c) and laser-treated rats (to the bone marrow at 4 and 48 hrs and 5 days) (b, d) taken 2 weeks post-MI. Note that the zone in the control non-laser-treated rats contains mainly collageneous mate- rial with a few desmin immunopositive cells in the infarcted area (a, c); while in the laser-treated rats the zone displays posi- tive desmin staining in extended outgrowths (arrow) from the myocardium (MC) in (b), and in the cytoplasm of many cells in the infarcted area in (d). IF, Infarcted area. Bar = 50 μm.

farcted area showed higher immunostaining for desmin in the laser-treated rat hearts as compared to the control non-treated ones (Figure 2). The cell density of desmin immune-positive cells was also determined quantitatively in histological sections of both the infarcted laser-treated rats and infarcted non-laser-treated rats. The cell density was significantly (p < 0.01) 3-fold higher in the infarcted area of the laser-treated rats as compared to the non-la- ser-treated controls (Figure 4).

The electron micrographs of all samples taken from the control non-laser-treated infarcted rat hearts revealed a typical interphase area between intact and infarcted heart (Figure 5(a)). Adjacent to the non-ischemic intact myocardium there were conspicuous fibroblasts with col- lagen deposition dispersed among them (Figure 5(a)). In all samples taken from the laser-irradiated hearts the in- terphase zone between intact and infarcted area demon- strated different characteristics to those of the non-laser- treated infarcted rat hearts. Cells with newly-formed or- ganized contractile myofilaments dispersed in the cyto- plasm were detected in groups of several cells (Figure 5(b)). In these cells numerous mitochondria, clusters of ribosomes, and conspicuous clusters of contractile pro- teins were evident in the cytoplasm (Figures 6-8). Some cells contained dispersed contractile myofilaments in the cytoplasm that were still in an early stage of organization (Figure 6). The organization of newly-formed contractile myofilaments in the cytoplasm was observed in various

Figure 3. Representative desmin immunostained light micro- graphs of the interphase of the infarcted zone of laser-treated rats. Note that desmin positively stained cross-sections of myo- fibers (arrows) intermingled in the infarcted zone in (a). In (b) immunopositively stained cross-sections of myofibers (arrow) are visible in the infarcted area (IF). In (c) newly-formed car- diomyocytes (NC) are seen, with the desmin immunostaining mainly confined to the Z-line. Bar = 50 μm.

Figure 4. Density of desmin positively stained area (relative to total area) in the infarcted areas of control (non-laser-treated) and laser-treated (to the bone marrow) rats at 14 days post-MI. Results are mean+ S.E.M from 6 - 8 rats in each group. **p < 0.01.

Figure 5. Electron micrographs of typical interphase zone be- tween myocardium and infarcted area of control non-laser- treated (a) and laser-treated (b) to bone marrow rats. Note intact myocardium (MY) and adjacent fibroblast (FB) in the infarcted area surrounded by collagen (CL) deposition in (a). In (b) sev- eral newly-formed cardiomyocytes (marked with asterix) with conspicuous well-organized myofilaments (MF) in their cyto- plasm are evident adjacent to blood capillaries (CA). EN, En- dothelial cell.

degrees of maturation in those cells. In some cells the myofilaments were dispersed in the cytoplasm and in others they were organized in clusters anchored to well- developed Z-lines (Figure 7(a)). In certain cells the myo- filaments were organized parallel to the longitudinal di- rection of the cells, resembling the morphological char- acteristics of mature intact cardiomyocytes (Figure 7(b)). Some of the cells were also seen in a process of forma- tion of typical intercalated disc between them (Figure 9).

4. DISCUSSION AND CONCLUSION

The most significant outcome of this study was the ap- pearance of newly-formed cardiomyocytes following laser treatment to the BM, as indicated by light and electron microscopy. There was a 3-fold increase in the density of

Figure 6. Electron micrographs of most probably newly-formed cardiomyocytes at an early stage of organization of contractile myofilaments. Note myofilaments (MF) in the cytoplasm. M, Mitochondrion. Bar = 1 μm.

Figure 7. Electron micrographs of most probably newly-formed cardiomyocytes with early (a) and late (b) stages of the organi- zation of the contractile myofilaments in the cytoplasm. Note contractile myofilaments that are dispersed (DMF) in the cyto- plasm with a few organized in clusters anchored to Z-lines (Z) in (a). In (b) myofilaments (MF) are organized in parallel to the longitudinal axis of the cardiomyocyte, resembling their orga- nization in mature cardiomyocyte. N, Nucleus. Bar = 1 μm.

desmin immunostained cells in the infarcted rat hearts that had been laser treated. Desmin is a protein found in the cytoplasm of developing myocytes and cardiomyo- cytes [32]. The significantly higher occurrence of des- min-positive cells in the infarcted area of the laser- treated hearts may indicate the synthesis of new contrac- tile proteins in the developing new cardiomyocytes, re- sembling the process that takes place during embryonic development. The ultrastructural features of the cells in the interphase between the intact myocardium and the

Figure 8. Electron micrographs of typical interphase zone be- tween myocardium and infarcted area of laser-treated infarcted rat heart. Note numerous mitochondria (M) in the cytoplasm of the cardiomyocytes in (a) and (b). Also note organized contrac- tile myofilament with well-developed Z-lines (Z), some dis- persed myofilaments and clusters of ribosomes (R). Bar = 1 μm.

Figure 9. Electron micrographs of typical intercalated disk formation in the interphase region of the infarcted heart of la- ser-treated rats. Formation of intercalated disks (ID) between cells (marked with asterix) is evident. Note that the most proba- bly newly-formed cardiomyocytes contain clusters of myofila- ments (MF) in the cytoplasm that are conspicuous in their obli- que or cross-sections (arrows). Bar = 1 μm.

infarcted myocardium of the laser-treated rats, as shown in this study, clearly resemble the characteristics of car- diomyocytes during embryonic development of the heart [33]. Furthermore, the clusters of ribosomes and the nu- merous clusters of mitochondria in the cytoplasm of these cells may characterize cells that are active in the synthe- sis of proteins. It was previously demonstrated that direct LLLT to the infarcted hearts of rats, dogs and pigs caus- ed a significant reduction of scarring post-MI [23,24]. It was suggested that part of this reduction could be ex- plained by the regenerative response that takes place in the interphase zone [24].

The results of the present study indicate that the LLLT

applied to autologous BM attenuates the concentration of macrophages and MSC in the circulating blood. We have previously shown that LLLT application to the BM of infarcted rats caused a 2 fold enhancement in the rate of proliferation of MSC in the BM [30]. Those cells that most probably leave the BM to the circulating blood in- deed show a significant elevation of their concentration (as reveled by the FACS analysis in the present paper) at 5 days post MI. Consequently these cells probably home in on the infarcted heart, and even migrate specifically to the infarcted area [30]. These cells may induce cardiac stem cells to differentiate to newly-formed cardiomyo- cytes, as suggested previously by Hatzistergos et al. [14]. Indeed, it was found that endogenous c-kit+ cardiac stem cells were increased by 20-fold in the rat infarcted heart compared to control, following transcardial injection of BM-derived MSCs [14]. Such induction may be enabled due to paracrine secretion of various growth factors by the laser-stimulated MSC that originated from the BM. The possibility that paracrine secretion occurs in im- planted stem cells during cell therapy to the heart post- MI has been suggested previously [34]. Another mecha- nism that may take place after homing of stem cells to the infarcted heart of the laser-stimulated rats is that these cells continue to proliferate in the appropriate mi-lieu of the interphase zone in the infarcted heart and then differentiate to cardiomyocytes [30].

Another possible mechanism that maybe associates with the reduction of infarct size is the significant increase in the concentration of macrophages in the circulation fol- lowing LLLT to the BM as revealed from the FACS analysis in the present study. These findings corroborate with studies indicating that macrophages activity in the infarcted area at early stages post MI cause reduction of scarring post MI [35,36]. Thus, it could be postulated that more macrophages that will eventually home in the infarcted area from the circulating blood in the laser treated rats will also contribute to the reduction of scar- ring.

Although the findings of the present study do not in- dicate the extent of regenerative capacity of the rat in- farcted heart post-laser-irradiation, they do reveal a shift from practically no cardiomyocytes in the tissue samples taken from the non-laser-treated hearts, to the presence of newly-formed cardiomyocytes in all the electron mi- croscope sections taken from the hearts of rats that are laser-treated to the BM.

In conclusion, to the best of our knowledge, this is the first study to demonstrate the appearance of newly-form- ed cardiomyocytes in the infarcted area following LLLT to autologous BM in the infarcted rat heart. The mecha- nisms associated with this phenomenon remain to be elu- cidated in further studies.

5. ACKNOWLEDGEMENTS

This study was partially supported by the Elizabeth and Nicholas Shle- zak Super-center for Cardiac Research and Medical Engineering. The authors wish to acknowledge N. Paz for editing the manuscript and V. Wexler for helping with preparation of the figures.

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Tuby, H., Maltz, L. and Oron, U. (2007) Low-level laser irradiation (LLLI) promotes proliferation of mesenchy- mal and cardiac stem cells in culture. Lasers in Surgery and Medicine, 39, 373-378. doi:10.1002/lsm.20492

[28]

Li, W.T., Leu, Y.C. and Wu, J.L. (2010) Red-light light- emitting diode irradiation increases the proliferation and osteogenic differentiation of rat bone marrow mesenchy- mal stem cells. Photomedicine and Laser Surgery, 28, S-157-S-165. doi:10.1089/pho.2009.2540

[29]

Mvula, B., Moore, T.J. and Abrahamse, H. (2010) Effect of low-level laser irradiation and epidermal growth factor on adult human adipose-derived stem cells. Lasers in Medical Science, 25, 33-39. doi:10.1007/s10103-008-0636-1

[30]

Tuby, H., Maltz, L. and Oron, U. (2011) Induction of au- tologous mesenchymal stem cells in the bone marrow by low-level laser therapy has profound beneficial effects on the infarcted rat heart. Lasers in Surgery and Medicine, 43, 401-409. doi:10.1002/lsm.21063

[31]

Oron, U. (2011) Light therapy and stem cells: A thera- peutic intervention of the future. Journal of Interventio- nal Cardiology, 3, 627-629.

[32]

Toma, C., Pittenger, M.F., Cahill, K.S., Byrne, B.J. and Kessler, P.D. (2002) Human mesenchymal stem cells dif- ferentiate to a cardiomyocyte phenotype in the adult mu- rine heart. Circulation, 105, 93-98. doi:10.1161/hc0102.101442

[33]

Oron, U. and Mandelberg, M. (1985) Focal regeneration in the rat myocardium following cold injury. Cell Tissue Research, 241, 459-463. doi:10.1007/BF00217194

[34]

Mummery, C.L., Davis, R.P. and Krieger, J.E. (2010) Challenges in using stem cells for cardiac repair. Science Translational Medicine, 14, 1-5.

[35]

van Amerongen, M.J., Harmsen, M.C., van Rooijen, N., Petersen, A.H. and van Luyn, M.J. (2007) Macrophage dep- letion impairs wound healing and increases left ventricu- lar remodeling after myocardial injury in mice. American Journal of Pathology, 170, 1093-1103. doi:10.2353/ajpath.2007.060547

[36]

Okazaki, T., Ebihara, S., Asada, M., Yamanda, S., Saijo, Y., Shiraishi, Y., Ebihara, T., Niu, K., Mei, H., Arai, H. and Yambe, T. (2007) Macrophage colony-stimulating factor improves cardiac function after ischemic injury by induc- ing vascular endothelial growth factor production and sur- vival of cardiomyocytes. American Journal of Pathology, 171, 1093-1103. doi:10.2353/ajpath.2007.061191


Original Source: http://www.scirp.org/journal/jbise

LLLT for Traumatic Brain Injury (TBI)

Michael Hamblin - 2013 (Video)
Dr Hamblin is associated with Harvard and the Wellman center. He is a distinguished author and spokeman for all type of medical lasers but he is also associated with Thor.
View Resource

Dr. Hamblin discusses the use of low level laser therapy for all type of brain injuries. He is an expert in all type of light healing (see below). He has performed much of his research on rats. He claims several key points:

  • 10 Hertz is the preferred pulsing frequency for the brain
  • 810nm is the preferred wavelength for cell interaction.
  • The best treatment period is about 7 sessions but  less than 14 days of  treatments. Going to longer term treatments seems to reduce the effectiveness.

This video is mainly about TBI but the principals are universal. Dr Hamblin is associated with Thor laser so there is some potential for bias but he is also assocated with Harvard and the Wellman Centre. Introduction to Low Level Laser Therapy (LLLT) for Traumatic Brain Injury (TBI) by Mike Hamblin. Wellman Centre for Photomedicine, Harvard Medical School.

 

video length: (6:18)

This video is restricted for minors.


Original Source: https://www.youtube.com/watch?v=sl5T1Lw0B5o

Dr Michael Hamblin: Harvard Professor and Infrared Therapy Expert

Dr. Michael Hamblin - 2015 (Video)
Dr. Hamblin is a Harvard professor and has been studying the effects of LLLT for many years, but he is also associated with Thor.
View Resource

In this video Dr. Michael Hamblin is interviewed by youtuber Selfhacked. Dr. Hamblin discusses the use of red and near infrared light in low level light therapy, he talks about the different possibilities of LLLT as well as some of his personal experiences with LLLT. He explains the reasons behind some of the effects from LLLT noticed in patients over the years, including it's effect on calcium in cells, ion channels, and infrared light vs. ultraviolet light. Dr. Hamblin also notes the differences between LLLT, bright light therapy, and light from the sun that is used for theraputic purposes. The majority of the video is spent discussing the effect of LLLT on the brain specifically.

video length: (52:08) 


Original Source: http://selfhacked.com/2015/07/18/interview-with-dr-michael-hamblin-harvard-professor-and-infrared-therapy-expert/

TheraLazr Cold Laser Treatment of Parkinson Tremor

Dr. Stephen Riner D.C. - YouTube 2012 (Video)
Dr. Riner uses LLLT to treat a patient with Parkinsons, the video shows the progression of the treatment
View Resource

This video shows before and after treatment footage of a patients with advanced Parkinsons. Treatment lasts about 2 weeks. Dr Riner is using the brain and neurostim setting on the brain, C5 Nerve Root and the Ulnar nerve in the elbow.

The TheraLazr is the prototype for the Avant LZ30 series of lasers.

 

video length: (2:03)


Original Source: https://www.youtube.com/watch?v=yOoV1AJ83-M

Epic 10 TMJ LLLT

- 2014 (Video)
A woman receives LLLT for her TMJ, and experiences no pain afterward, but the title promotes the Epic 10 laser, possible bias.
View Resource

LLLT being used to treat a patient with TMJ. She experiences pain in her cheeks and neck particularly, and afterward claims to have no pain or discomfort. The doctor states that the LLLT has reduced inflammation, and relaxed the muscles that were causing the spasms.

 video length: (2:43)


Original Source: https://www.youtube.com/watch?v=u28fAHZNRoQ

Oral Mucositis Academy of Laser Dentistry 2016

Annette Quinn - 2016 (Video)
After reviewing other treatment options like radiation, Annette talks about how extremely effective laser can be on oral mucositis
View Resource

The laser info starts around 30 minutes into the presentation.


Original Source: https://www.youtube.com/watch?v=xU5_9169dbw

LLLT for spinal cord injuries presented by Prof Juanita Anders

Prof Juanita Anders - YouTube 2011 (Video)
This is a 17 minute long presentation of LLLT research done on rats, the video is however associated with Thor
View Resource

The presentation includes research done on rats for the following conditions:

  • Traumatic Brain Injury (TBI)
  • Spinal Cord Injury
  • Nerve regeneration

The research was supported by Thor so it could be biased but their research indicates that 810nm provides better stimulation of the cells.

 

video length: (17:09)


Original Source: https://www.youtube.com/watch?v=XxRIds1EKqk

Deep Tissue Laser Therapy Medical Animation

- (Video)
This video was produced by LightCure so it is biased but it has one of the best graphic representation of the photobiomodulation using a therapy laser.
View Resource

In this video, you will see one of the best graphic representations of the photobiomodulation process including the release of ATP, NO, ROS.

This video was created by LightCure so at the end of the video, they try to make the point that class 4 laser are better than class 3 system. With the release of high-power class 3b (with power levels over 15 watts) system, this part of the video out of date.

 

video length: (3:08)


Original Source: https://www.youtube.com/watch?v=dB9MIW9fduk

Dr Burke, LLLT Patient Results

- 2014 (Video)
(GRAPHIC CONTENT) This relatively unbiased 14 minute long presentation focuses on the results of LLLT on multiple patients by Dr. Burke.
View Resource

Dr. Burke shares some of his quite impressive results in patients who recieved LLLT, incuding:

  • a woman with severe ulcers on her hand
  • a horse with a leg wound
  • an 88 year old woman with diabetes and an infected ulcer on her leg, soon to be amputated
  • a 68 year old woman with a non-healing knee surgury wound
  • a man with a 40 year old venous ulcer
  • a woman with blood clots in her feet that led to gangreen, soon to be amputated
  • a 12 year old girl with post herpetic Bell's Palsy
  • a man with very bad leg fracture
  • a woman with a jones fracture

video length: (13:46) 


Original Source: https://www.youtube.com/watch?v=iJunHg5VFUM

THOR Low Level Laser Therapy LLLT Wound healing

- 2008 (Video)
This video is a news report on LLLT, and it shows some promising results on a year old non-healing hernia, the video was posted to youtube by thor, possible bias.
View Resource

News report about the use of low level light therapy (LLLT) on a surgical wound that wouldn't heal after nearly a year in a patient with diabetes.

 

video length: (2:17) 


Original Source: https://www.youtube.com/watch?v=faYpG_IOi08

LLLT treatment of Oral Mucositis

- 2008 (Video)
This is a news report that explains the basics of LLLT and we hear from a patient that it was used to treat Oral Mucositis, the video was posted by thor, could be biased
View Resource

Young man with mucositis recieved a bone marrow transplant and was given LLLT both pre-, and post-op. He was expected to have serious mouth sores, but thanks to the LLLT he had minimal sores that quickly went away.

video length: (1:35) 


Original Source: https://www.youtube.com/watch?v=9Mfrrga40yw

Pain Relief, Accelerated Healing with Laser Therapy, Chad Davis, DVM

- 2011 (Video)
This is a video of Chad Davis, DMV, demonstrating the use of LLLT on A horse, it was made using a multi radiance laser so it may be biased
View Resource

Chad Davis, DVM, gives a demonstration of the effecacy of LLLT on a horse.

 video length: (4:39)


Original Source: https://www.youtube.com/watch?v=nIwFJ2OHKms

RJ-LLLT in paralyzed dogs prevents surgery...

- 2014 (Video)
In this video you will see before and after LLLT on 3 different paralyzed dogs, made by RJ Lasers could be biased
View Resource

This short video shows 3 before and after videos of paralized dogs who recieved LLLT and were able to walk again.

video length: (1:25) 


Original Source: https://www.youtube.com/watch?v=McfHhMNo13I

Low Level Laser Therapy (LLLT): An Introduction

QB Medical - 2014 (Video)
This is a 12 minute introductory video to LLLT
View Resource

This video discusses the basics of Low Level Laser Therapy. You will learn a little bit about lasers and laser history, and what makes a cold laser a cold laser. It also talks about the difference between lasers and LED's and why the latter may be less effective for medical therapy.

You'll find information on the treatment parameters of LLLT which are:

  • wavelength
  • power
  • duty cycle (continueous or pulsed)
  • energy density (dosage)
  • treatment duration

It also goes over what indications the FDA has approved LLLT and infrared light for.

 video length (12:13)


Original Source: https://www.youtube.com/watch?v=vnvOKXSLK8E

Introduction to LLLT

Dr. Michael Hamblin - 2009 (Video)
Dr. Hamblin is a Harvard professor and has been studying the effects of LLLT for many years, but he is also associated with Thor.
View Resource

 Dr. Michael Hamblin Talks about the differences between photodynamic therapy (PDT) and low level laser therapy (LLLT), and explains the basics of LLLT.

video length: (4:35) 


Original Source: https://www.youtube.com/watch?v=7DdxPWmQPHk

Cold Laser Therapy of Knee Pain, Knee Sprains, Knee Tendinitis, and Chondromalacia Patella.

- 2013 (Video)
This video talks about what LLLT is and touches on the differences between class III and IV lasers for LLLT
View Resource

Class IV K Laser is an excellent new treatment for helping muscle pulls, sprains, strains, and joint injuries. Cold Laser is a great treatment for speeding the recovery of knee pain, chondromalacia patella, patella tendonitis, and knee sprains. Lasers help increase cellular ATP, which is the cells energy source. Cells use the increased energy for healing and repair. Lasers are also excellent at increasing metabolic and repair process within the tissue. They decrease inflammation and pain around muscles, tendons, and joints. In addition, the speed recovery and healing of nerves, especially pain nerves.

video length: (1:51) 


Original Source: https://www.youtube.com/watch?v=joh2jlWErsY&nohtml5=False

Cold Laser Therapy Treatment for Neuropathy caused by Diabetes

- 2013 (Video)
Dr. Adam Zuckerman talks about his use of LLLT in patients with diabetes.
View Resource

 Dr. Adam Zuckerman talks about his use of LLLT in patients with diabetes.

video length: (1:46) 


Original Source: https://www.youtube.com/watch?v=pmDVhtNqJXA&nohtml5=False

Ron Hirschberg DVM veterinarian, interview about LLLT low level laser therapy

Ron Hirschberg - 2013 (Video)
In this 13 minute video Ron Hirschberg, DMV, tells of his personal experience with LLLT, and on to his use of LLLT in his veterinary practice, the video is made by thor, so it could be biased
View Resource

Veterinarian Ron Hirschberg tells of how he first experienced laser therapy on his own arthritis, and decided to invest in lasers for his practice. Since he started using laser therapy on the pets he works with he has seen many positive results, he explains that gross profits from NSAIDs decreased from 0.71% to 0.3%, and laser profit now makes up 4% of the practice's income. He will treat between 3 and as many as 13 patients with LLLT, 95% of which he says improve noticably faster than those without LLLT.

viedo length: (13:37) 


Original Source: https://www.youtube.com/watch?v=MLmE8QE27Ew

Recovery, Training and the Olympic Trials with NovoTHOR

Thor Lasers - Youtube (Video)
This is a marketing video for the NovoThor staring several several Olympic athletes.

Lyme Laser Centers of New England - Hanna

Lyme Laser Centers of New England - Youtube (Video)
Here is a testmonial for using laser therapy to treat lyme disease.

Lyme Laser Centers of New England - Lauren

Lyme Laser Centers of New England - Youtube (Video)
Here is a testmonial for using laser therapy to treat lyme disease.

Lyme Laser Centers of New England - Sarah

Lyme Laser Centers of New England - Youtube (Video)
Here is a testmonial for using laser therapy to treat lyme disease.

Lyme Laser Centers of New England - Meghan

Lyme Laser Centers of New England - Youtube (Video)
Here is a testmonial for using laser therapy to treat lyme disease.

Spokane Chiropractor, Chiropractic Lifecenter, Cold Laser Therapy

- 2010 (Video)
This is a short video demonstration of LLLT on a woman with restricted motion in her shoulders
View Resource

In this video Spokane Chiropractor Dr. Patrick Dougherty gives a quick demonstration of how cold laser therapy is used as a chiropractic treatment to help with range of motion by affecting the nervous system. This can be used as an effective adjunct to chiropractic adjustments when the brain is having a difficult time holding on to the input that the adjustments provides to the brain.

video length: (4:34) 


Original Source: https://www.youtube.com/watch?v=vzGqgzKC76I&nohtml5=False

How LLLT Works

- (Video)
This is an animation that helps to explain the processes behind LLLT, it is made by Thor so it may be biased
View Resource

This short animation from gives a simple description of how LLLT effects individual cells and things like:

  • cytochrome c oxidase
  • oxygen
  • NADH
  • Nitric oxide
  • ATP 

video length: (1:21) 


Original Source: https://www.youtube.com/watch?v=VzMJUxalkFo

Cold Laser Therapy for Pain, Arthritis, Neck Pain

- 2011 (Video)
Dr. Larry Lytle discusses LLLT, particularly for pain in an interview.
View Resource

Dr. Larry Lytle discusses LLLT, particularly for pain in an interview.

video length: (27:37) 


Original Source: https://www.youtube.com/watch?v=VocXsehAb2c&nohtml5=False

Dr. Victor Dolan Demonstrates Cold Laser Therapy

- 2011 (Video)
Dr. Dolan demonstrates LLLT on a sore back, while describing how LLLT works.
View Resource

Cold Laser Therapy can be very effective for those suffering from pain caused by auto accidents. Cold Laser Therapy is equally effective for those suffering from pain caused by work-related accidents. Athletes get great relief from sports-related injuries using Cold Laser Therapy. Cold Laser Therapy is a powerful therapy in the battle to relieve back pain, neck pain and joint pain. 

Importantly, studies to date indicate that Cold Laser Therapy has no serious side effects when used by a trained healthcare professional. It is a non-invasive procedure requiring no surgical incision. There is no recovery time after a treatment. You do not have to take any medications relating to Cold Laser Therapy.

 video length: (5:49)


Original Source: https://www.youtube.com/watch?v=paixoR44Bv0&nohtml5=False

LLLT Neck Pain Treatment

- 2008 (Video)
A video of an LLLT procedure for neck pain
View Resource

Using LLLT to treat neck pain, procedure without wavelength or power, or any other laser parameters given.

video length: (1:14) 


Original Source: https://www.youtube.com/watch?v=0gb0m1uFbhU

Cold Laser Therapy Demonstration? Austin Natural Family Medicine

- 2010 (Video)
Dr. Fritz describes what LLLT is while giving a basic demonstration of the process
View Resource

Dr. Fritz teaches Obstetrics & Gynecology at the Academy for Oriental Medicine in Austin.

After getting undergraduate and graduate degrees in Biology from the University of Virginia, Dr. Vanessa Fritz graduated from the National College of Natural Medicine in Portland, Oregon, with a doctorate in Naturopathic Medicine (ND) as well as a Master of Science in Oriental Medicine (MSOM). 

video length: (9:32)


Original Source: https://www.youtube.com/watch?v=mS6-o_iBDGE&nohtml5=False

Introduction to Cold Laser Therapy

- 2016 (Video)
Dr. Christensen shares an introduction to cold lasers, their benefits and many uses
View Resource

 

video length: (11:05) 


Original Source: https://www.youtube.com/watch?v=HDzu7bzpLy0

LLLT presentation HD

- 2015 (Video)
This 20 minute long video presentation gives a basic description of LLLT and a list of dental issues LLLT has been used to treat, the video is specific to zolar laser, so it may be biased
View Resource

This video gives a somewhat in-depth list of dental issues that LLLT can be used to treat and how to treat them, along with a simple explaination of what LLLT is. At (16:48) there is a demonstration on how to use a Zolar laser for LLLT.

video length: (19:49) 


Original Source: https://www.youtube.com/watch?v=ZJIEx9qemhk

K-Laser Mechanism of Action, Animal

- 2012 (Publication)
This is a great K-laser graphic review of the mechanism for 970nm increasing circulation and 905nm for boosting oxygen and 800nm for boosting cytrochrome oxydase to produce more ATP.
View Resource

This video shows how red laser light interacts with blood and it talks in detail about the chemical process.

 

K-Laser Mechanism of Action, Animal from K-LaserUSA on Vimeo


Original Source: https://vimeo.com/49623761

Plantar Fasciitis, Achilles Tendonitis, Morton’s Neuroma - LLLT treatment using the FOX Laser

- 2015 (Video)
This is a video demonstration of how to use a fox laser for LLLT for foot problems
View Resource

LLLT is known to dramatically improve conditions associated with soft tissue inflammations, not only by reducing pain, but also by providing a significant therapeutic advantage resulting in inflammation reduction, as well as expediting the healing process.

  • Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed, resulting in heel pain. The most common cause of plantar fasciitis relates to faulty structure of the foot. Wearing non-supportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis. 
  • Achilles tendinitis is an overuse injury of the Achilles tendon, the band of tissue that connects calf muscles at the back of the lower leg to your heel bone. The structure of the Achilles tendon also weakens with age, which can make it more susceptible to injury — particularly in people who may participate in sports only on the weekends or who have suddenly increased the intensity of their running programs
  • A neuroma is a thickening of nerve tissue that may develop in various parts of the body. The most common neuroma in the foot is a Morton’s neuroma, which occurs between the third and fourth toes. It is sometimes referred to as an intermetatarsal neuroma. Morton's neuroma seems to occur in response to irritation, pressure or injury to one of the nerves that lead to the toes.

video length: (3:25) 


Original Source: https://www.youtube.com/watch?v=q4ASHpHcn8w

A guy with dentine hypersensitivity treated with LLLT

- 2015 (Video)
A man who has just been treated with LLLT for his dentine hypersensitivity, video posted by Thor so it could be biased
View Resource

A man experiencing tooth sensitivity atests to pain reilief from LLLT.

video length: (0:54)



Laser Therapy Review Pain Management - Dr. Bernard Filner MD - Microlight ML830® Laser

- 2011 (Video)
Dr. Bernard Filner MD Discusses his use of LLLT in pain management, but the video is made by microlight so it may be biased
View Resource

Dr. Bernard Filner MD Discusses his use of LLLT in pain management.

video length: (2:48) 


Original Source: https://www.youtube.com/watch?v=fIlU4QDAuW0&nohtml5=False

How Theralase Laser Technology Works

Theralase - 2016 (Video)
This is a biased promotional video but the graphic are a good intro to the chemical process.

Laser Therapy Review - Sue Hale PT - ML830® Cold Laser

- 2012 (Video)
A physical therapist describes her usage of LLLT both personally and professionally, video specific to a microlight laser so it could be biased
View Resource

Sue Hale, Physical Therapist. Hand therapist in Melbourne FL. Sue speaks of her experiences using the Microlight ML830® Cold Laser in her practice and personally. Sue uses the ML830® Laser daily for treating all types of injuries; from hand injuries, back pain and injuries, runner's injuries, knee injuries, and many other conditions. 

video length: (1:17) 


Original Source: https://www.youtube.com/watch?v=m2kYC8DGFJ8&nohtml5=False

Cold Laser Therapy for Dogs and Cats

- 2013 (Video)
This video shows several pets with their owners after LLLT
View Resource

 

video length: (5:18) 


Original Source: https://www.youtube.com/watch?v=f0VslA0kwPE

Recovery of Django the Dog

- 2015 (Video)
(3 short videos) Django the dog has a grade 2 medial patellar luxation, and receives LLLT before and after surgery to alleviate pain.
View Resource

Django's 1st Low Level Laser Therapy (LLLT)

Django is now 13 months old and has had clicking and obvious pain in his right knee for the last 6 months. After a negative valley fever test & 2 knee x-rays showing no fracture or tumors,and being told by 2 vets, it's possibly a soft tissue (CCL/ACL) injury and that he needed a CT, MRI or arthroscopy to get a more definitive diagnosis. Django's owner decided to try LLLT to alleviate some of his pain.

video length: (0:32) 

 

Django Post MPL Surgery Days 1-2

Django had surgery (medial imbrication, with a lateral release & anti-rotational sutures) on his left knee to correct a grade 2 medial patellar luxation August 20, 2015-. Here he is the day of surgery from check in through 48 hours later getting cold laser therapy.

video length: (1:27)

Loving Life

Here's Django approximately 9 weeks post-op, fully enjoying the newfound use of his leg.

video length: (1:41)

More videos of Django's journey can be found on his owner's Youtube channel, link below.


Original Source: https://www.youtube.com/channel/UCVCp5py29hdRoosgAJ_qIbA

Using Cold Laser Therapy to Help Children with Learning Disabilities

- 2015 (Video)
A video of a young man who received LLLT for learning disabilities, the video was made by the clinic that treated him, so keep that in mind
View Resource

 The young man featured in this video had a history of cognitive issues, including difficulty with reading and comprehension.

video length: (1:54)


Original Source: https://www.youtube.com/watch?v=u5Zs3NSefa4

Avant LZ30 Instructional videos

- 2015 (Video)
(3 5ish minute videos) These videos show you how to use and be safe with the Avant LZ30 family of lasers
View Resource

This video covers the operation of the LZ30 family of lasers in Basic Mode.

video length: (3:47) 

 

 

This video covers the Advanced Features of the LZ30 family of lasers.

video length: (6:17) 

 

This video covers Safety and Regulatory Considerations for the use of the LZ30 family of lasers.

video length: (3:49) 


Original Source: https://www.youtube.com/watch?v=pkSYuEIxZc0&nohtml5=False

Class 3B vs Class 4 laser therapy penetration

- 2012 (Video)
Penetration depth test between a high powered class 4 970nm laser and a low powered class 3b LLLT 810nm laser, by shining through hand, this is made by Thor, could be biased
View Resource

Penetration depth test between a high powered class 4 970nm laser and a low powered class 3b LLLT 810nm laser, by shining through hand.

  • Class 4 Laser: 11-55mW went through hand
  • Class 3b LLLT Laser: 55-90mW went through hand

Result: 810nm laser passes through tissue better than 970nm Laser

video length: (3:09) 


Original Source: https://www.youtube.com/watch?v=UASgE-yO8Xk

Cold Laser Therapy speeds healing for Dogs and Cats

- 2013 (Video)
This is a video demonstration of LLLT on a dog with inflammation and pain in his paw
View Resource

Demonstration of LLLT on a dog with inflammation, and pain in his paw.

video length: (3:36) 


Original Source: https://www.youtube.com/watch?v=Hg4ruVCNp7o&nohtml5=False

The energy density of laser light differentially modulates the skin morphological reorganization in a murine model of healing by secondary intention.

Novaes RD1, Gonçalves RV, Cupertino MC, Araújo BM, Rezende RM, Santos EC, Leite JP, Matta SL. - Int J Exp Pathol. 2014 Apr;95(2):138-46. doi: 10.1111/iep.12063. Epub 2013 Dec 20. (Publication)
This study on scar tissue found that higher energy density investigated was more effective in modifying the morphology of the parenchyma and stroma of the scar tissue and led to a faster healing. The max tested and best dosage was found to be 30 J/cm(2).
View Resource

Abstract

This study investigates the influence of gallium–arsenide (GaAs) laser photobiostimulation applied with different energy densities on skin wound healing by secondary intention in rats. Three circular wounds, 10 mm in diameter, were made on the dorsolateral region of 21 Wistar rats weighting 282.12 ± 36.08 g. The animals were equally randomized into three groups: Group SAL, saline solution 0.9%; Group L3, laser GaAs 3 J/cm2; Group L30, laser GaAs 30 J/cm2. Analyses of cells, blood vessels, collagen and elastic fibres, glycosaminoglycans and wound contraction were performed on the scar tissue from different wounds every 7 days for 21 days. On day 7, 14 and 21, L3 and L30 showed higher collagen and glycosaminoglycan levels compared to SAL (P < 0.05). At day 21, elastic fibres were predominant in L3 and L30 compared to SAL (P  < 0.05). Type-III collagen fibres were predominant at day 7 in both groups. There was gradual reduction in these fibres and accumulation of type-I collagen over time, especially in L3 and L30 compared with SAL. Elevated density of blood vessels was seen in L30 on days 7 and 14 compared to the other groups (P < 0.05). On these same days, there was higher tissue cellularity in L3 compared with SAL (P < 0.05). The progression of wound closure during all time points investigated was higher in the L30 group (P  < 0.05). Both energy densities investigated increased the tissue cellularity, vascular density, collagen and elastic fibres, and glycosaminoglycan synthesis, with the greater benefits for wound closure being found at the density of 30 J/cm2.

Keywords: laser photobiostimulation, morphology, pathology, skin repair, wound healing, collagen

Laser photobiostimulation has been used as a non-invasive alternative to treat muscle injuries and skin wounds, and to control inflammatory processes and pain (Enwemeka et al. 2004; Reddy 2004). Although the use of laser light to accelerate the healing process was documented in the literature for the first time in 1971 (Mester et al. 1971; Shields & O'Kane 1994), and the efficacy of this therapeutic modality is proven, parameters about how it is used are still controversial (Tuner & Hode 1998; Moore et al. 2005). Parameters such as the type and source of laser light emission, number of applications, duration of treatment and mechanisms of action through which the laser light exerts its effects remain the focus of investigation in the ongoing search for efficient methodologies that justify and encourage the use of laser light in clinical practice. Several mechanisms have been proposed to explain the effects of laser light on biological tissues, including the absorption of light by the enzymes of the electron transport chain in the inner mitochondrial membrane, stimulation of the production of oxygen, and cell proliferation induced by photoactivation of the calcium channels (Shields & O'Kane 1994; Breitbart et al. 1996). Recent studies show that the main cells stimulated by laser light are macrophages and fibroblasts (Gonçalves et al. 2010a; Xavier et al. 2010). Macrophages are important cells responsible for releasing growth factors that stimulate proliferation, differentiation and synthesis of extracellular matrix components (Shields & O'Kane 1994; Reddy 2004; Gonçalves et al. 2010b). In in vitro experimental models examination of a wide range of wavelengths showed that wavelengths between 524 nm and 904 nm were related to decreased time of wound healing by stimulating fibroblast and keratinocyte differentiation, collagen production and skin neovascularization (Pogrel et al. 1997; Demidova-Rice et al. 2007).

Previous studies have shown that the gallium–arsenide laser (GaAs λ 660 nm) is able to stimulate skin wound healing in humans and laboratory animals with energy densities between 1 and 4 J/cm2 (Medrado et al. 2003; Pugliese et al. 2003; Reddy 2004). However, most of the work is restricted to investigating the effect of energy densities below 4 J/cm2, and reports on the effects of high energy densities in tissue repair are scarce and inconclusive. Thus, this study was designed to investigate the influence of laser photobiostimulation applied with different energy densities in a rat model of skin wound healing by secondary intention.

Materials and methods

Animals

Twenty-one male Wistar rats (Rattus norvegicus), 10 week old and weighing 282.12 ± 36.08 g, obtained from the Biological Sciences Center, Federal University of Viçosa, Minas Gerais, Brazil, were used in this study. During the experiment, the animals were allocated to individual cages that were cleaned daily and maintained in an environment with controlled temperature (22 ± 2 °C), light (12 h light/dark cycles) and humidity (60–70%).

Ethical approval

The experiment was conducted in accordance with International Ethical Standards for the Care and Use of Laboratory Animals and approved by the Ethics Committee for the Care and Use of Laboratory Animals of the Federal University of Viçosa (UFV; registration 005/2008).

Experimental protocol

Before the surgical wounds were made, the animals were anaesthetized using intramuscular ketamine (50 mg/kg) and xylazine (20 mg/kg). Then, trichotomy was performed on the dorsolateral region of the animals, and the area was defatted using ethyl ether (Merck®, Rio de Janeiro, Brazil) followed by the use of 70% ethanol and 10% povidone–iodine for anti-sepsis (Johnson Diversey®, Rio de Janeiro, Brazil). Three circular secondary intention wounds 10 mm in diameter were made in the dorsolateral region of the animals by removing the skin with a scalpel until the exposure of the muscle fascia. The standardized wound area was marked with a dermographic pencil and checked using an analogical pachymeter (Kingtools®, São Paulo, Brazil) (Gonçalves et al. 2013). After completion of the wounds, the animals were randomly divided into three groups with seven animals in each. Group saline (SAL, control): saline solution 0.9%; Group L3: GaAs laser (λ 660 nm, 3 J/cm2); Group L30: GaAs laser (λ 660 nm, 30 J/cm2). The laser device (Endophoton®, KLD, São Paulo, Brazil), which was previously calibrated by the manufacturer, presented an output of 20 mW, power density of 25.47 mW/cm2, visible radiation and a 0.79 cm2 circular beam. Laser light was applied transcutaneously at six equidistant points around the wound margin. The wounds were irradiated for 118.5 s in L3 to release 3 J/cm2 and 1185 s in L30 to release 30 J/cm2. The wounds were cleaned daily with 0.9% saline solution immediately before the laser application. The treatments were started immediately after the wound was made once a day for 21 days corresponding to the experiment duration.

Analysis of wound contraction

The progress of wound closure was evaluated by measuring the wound area every 7 days in digitized images with the dimensions of 320 × 240 pixels (24 bits/pixel) obtained using a digital video camera (W320, Sony, Tokyo, Japan). The wound areas were calculated by computerized planimetry using the Image Pro-Plus image analysis software program, version 4.5, (Media Cybernetics®, Silver Spring, MA, USA), previously calibrated. Wound contraction index (WCI) was calculated using the following ratio: initial area of the wound (Ao) − area on the day of measurement (Ai)/initial area of the wound (Ao) × 100 (Gonçalves et al. 2013). The third wound was selected for this analysis because the tissue from this wound was collected on the final day of the experiment (21st).

Analysis of total collagen and glycosaminoglycans

For each group, 35 histological sections 8 μm thick stained with Fast green and Sirius red were used to quantify the levels of collagen and total protein in scar tissue using a previously described spectrophotometric method (López-De León & Rojkind 1985). In this method, the maximal absorbance to the Sirius red (540 nm) and Fast green (605 nm) dyes, correspond to the amount of collagen and non-collagen proteins respectively. For each section used in the collagen analysis, a corresponding serial section was obtained, which was used in the analysis of glycosaminoglycans. The tissue content of glycosaminoglycans was determined according to a modified procedure described by Corne et al. (1974). Sections were transferred immediately to 10 ml of 0.1% (w/v) Alcian blue 8GX solution (0.16 M sucrose solution buffered with 0.05 ml sodium acetate at pH 5). After successive rinses in 10 ml of 0.25 M sucrose solution, dye adhered to the tissue was extracted with 10 ml of 0.5 M magnesium chloride, and the absorbance of the resultant solution was analysed in a spectrophotometer at 580 nm.

Stereological analysis

Tissue fragments were collected from the different wounds every 7 days. Each fragment contained tissue removed from the centre of the wound and part of the uninjured adjacent tissue that had not received laser radiation. The fragments were put into Karnovsky's solution for 24 h and processed for paraffin embedding. Semiserial 4-μm-thick vertical uniform random (VUR) sections were obtained using a rotating microtome (Leica Multicut 2045®, Reichert-Jung Products, Jena, Germany). One of every 20 sections was used to avoid repeating analysis of the same histological area. Sections mounted on histology slides were stained with haematoxylin and eosin for visualization of cells and blood vessels (Karu 2003), Verhoeff's method for elastic fibres (Verhoeff 1908) and Sirius red dye (Sirius red F3B, Mobay Chemical Co., Union, NJ, USA) for marking collagen fibres observed under polarizing microscopy (Junqueira et al. 1979). Analysis of collagen was based on the birefringence properties of the collagen fibres, because under polarization, the thick collagen fibres (type I) appear in shades of bright colour ranging from red to yellow, whereas thin reticular fibres (type III) are shown in bright green (Gonçalves et al. 2010a).

The slides were visualized, and the images captured using a BX-60® light microscope (Olympus, São Paulo, Brazil) connected with a digital camera (QColor-3®, Olympus, São Paulo, Brazil). For each wound and staining method, 10 histological sections were analysed. For each section, five images were obtained randomly with a 20× objective lens, and the cells and blood vessels were quantified in the histological area. Under each image was applied an unbiased two-dimensional test area (At) of 69 × 103 μm2 at tissue level, so that the total histological area investigated was 24 × 106 μm2. The proportion of the histological area occupied by type-I and type-III collagen fibres was determined using the Quantum® software program (Department of Soil Science, Federal University of Viçosa, Viçosa, Brazil) (Gonçalves et al. 2010a).

The volume density of cells (Vv [cells], %), blood vessels (Vv [bvs], %) and elastic fibres (Vv [elf], %) was estimated as:

equation image
(1)

where ΣPp [cells; bvs; elf] denotes the total number of points on the cells, blood vessels or elastic fibres, and ΣPt is the total points of the test system (ΣPt = 200).

The length density of blood vessels (Lv [bvs], mm/mm3) and elastic fibres (Lv [elf], mm/mm3) was estimated as:

equation image
(2)

where ΣQ[bvs] denotes the total number of blood vessel or elastic fibre profiles counted in the At, and ΣP [tissue] is the total number of points on the tissue (Brüel et al., 2005).

The surface area density of blood vessels (Sv [bvs], mm2/mm3) was estimated as:

equation image
(3)

where ΣI [bvs] denotes the total number of intersections between the cycloid arcs (here 44) and the blood vessel surface area, and l is the length of the cycloid arcs. The Image Pro-Plus 4.5® image analysis software (Media Cybernetics) was used in the stereological analysis.

Data analysis

The data were expressed as mean and standard deviation (mean ± SD). The normalcy of the data distribution was verified using the Shapiro–Wilk test. All variables investigated were subjected to the Kruskal–Wallis test for multiple comparisons. Statistical significance was established at P < 0.05. The analysis was performed using the software Sigma Stat 3.0® (Systat Software Inc., Chicago, IL, USA).

Results

There were no significant differences in total collagen and glycosaminoglycan content in the uninjured tissues from the different groups (Table 1). At all investigated time points, the groups exposed to laser photobiostimulation had higher collagen content in the scar tissue compared with SAL (P < 0.05). At day 7, the content of glycosaminoglycans was higher in both groups exposed to laser irradiation in relation to SAL group. A similar result was observed at day 14, but only the group L30 was significantly different compared with SAL. At the end of the experiment, the content of glycosaminoglycans was significantly higher in L3 compared with the other groups.

Table 1
Levels of collagen and glycosaminoglycans in scar tissue of rats receiving laser light applied with different energy densities

The analysis of collagen fibres in the uninjured tissue showed no difference in the proportion of type-I and type-III fibres between the groups. On days 14 and 21, the groups receiving laser irradiation had higher proportion of type-I collagen fibres compared with SAL, with the best results in L30 (P < 0.05). At day 21, this variable was similar in L3 and L30. Animals in L3 and L30 had a higher proportion of type-III fibres compared with SAL on days 7 and 14, with the best results in L3 (P < 0.05). At day 21, the content of type-III fibres was similar in all groups (Figure 1).

Figure 1
Proportion of type-I and type-III collagen fibres in the scar tissue of rats receiving laser light applied with different energy densities. In B are shown representative photomicrographs of the scar tissue at the end of the experiment (day 21; Sirius ...

The analysis of elastic fibres in the uninjured tissue showed no difference in the proportion of volume and length of elastic fibres between the groups. On day 21, the groups receiving laser irradiation had a higher proportion of volume (Vv) and length (Lv) of elastic fibres (elf) compared with SAL (P < 0.05) (Figure 2).

Figure 2
Density of volume (Vv) and length (Lv) of elastic fibres (elf) in scar tissue of rats receiving laser light applied with different energy densities. The top panels are representative photomicrographs of the scar tissue at the end of the experiment (day ...

The extent of scar tissue occupied by blood vessels is shown in Table 2. There were no significant differences in volume, length or surface densities of blood vessels in the unharmed tissues (day 0). At day 7, all these parameters were significantly higher in both groups that received laser light compared with SAL, with better results in L30 (P < 0.05). On days 14 and 21, similar results were observed in L30 compared with other groups (P < 0.05).

Table 2
Density of length (Lv) and area (Sv) of blood vessels (bvs) in scar tissue of rats receiving laser light applied with different energy densities

The results of tissue cellularity are shown in Table 3. The unharmed tissue presented similar cellularity in all groups. On days 7 and 21, the groups L3 and L30 had higher cellularity in the granulation tissue compared with SAL (P < 0.05). At day 14, there was a higher volume density of cells in L3 compared with the other groups (P < 0.05).

Table 3
Volume density (Vv [cells], %) of cells in the histological area of the scar tissue of rats receiving laser light applied with different energy densities

Figure 3 colour shows photomicrographs of skin histological sections collected in both groups investigated. The uninjured skin showed similar cellularity and blood vessel density in all groups. On days 7, 14 and 21, there was increased cell distribution in all groups, with higher cellularity in L3 and L30 compared with the SAL (Figure 3 and Table 2). On days 7 and 14, increased density of blood vessels was observed mainly in the group L30 compared with the other groups. At day 21, there was a higher density of cells and blood vessels in both groups that received laser light compared with SAL.

Figure 3
Representative photomicrographs showing the distribution of cells and blood vessels in scar tissue of rats receiving laser light applied with different energy densities (H&E staining, bar = 30 μm). Tissue fragments ...

At all times investigated, the group L30 showed a significant reduction in the wound area compared with other groups (P < 0.05). At day 7, the rate of wound closure was higher in the groups receiving laser irradiation compared with SAL (P  < 0.05). A high rate of wound closure was identified in SAL at the end of the experiment (day 21). Total closure of the wound was achieved in L30 by day 21, a feature not found in the other groups (Table 4 and Figure 4).

Figure 4
Representative photomicrographs showing the progression of the closure of wound skin in rats receiving laser light applied with different energy densities. Tissue fragments were collected every 7 days during 21 days of treatment. SAL, 0.9% saline solution;L3, ...
Table 4
Progression of the closure of skin wounds in rats receiving laser light applied with different energy densities

Discussion

The present study investigated the effect of different energy densities of the GaAs laser on skin wound healing. Using design-based stereology and spectrophotometric methods, the results indicated that the laser photobiostimulation was able to modify the morphology of the scar tissue in a time-dependent way leading to more efficient healing.

It is widely recognized that for healing to occur properly, synthesis of extracellular matrix is required, especially collagen, a protein that provides structural support for cell proliferation and neoangiogenesis (Liu et al. 2008; Gonçalves et al. 2010a,b2010b). The results of this study showed that both groups that received laser irradiation had a higher total collagen content at all time points analysed. These findings corroborate the results found by Medrado et al. (2003) and Gonçalves et al. (2010a,b2010b), which observed a significant increase in the collagen content in scar tissue 7 days after laser irradiation of skin wounds in rats. Collagen synthesis is an event directly related to the biomechanical properties of the scar tissue. In this context, the greatest collagen content gives the scar tissue greater resistance to mechanical stresses, a characteristic essential to the maintenance of tissue integrity and to reduced susceptibility to further injury (Karu 2003; Gonçalves et al. 2010a,b2010b).

Considering the different collagen types, both irradiated groups had a higher proportion of type-I and type-III collagen fibres than the control group. Both energy densities investigated were effective in stimulating the maturation of collagen in scar tissue, and the best results were found in group L30. Although laser irradiation has influenced the total levels of collagen, it is essential to identify the types of collagen produced in scar tissue. Traditionally, the assessment of type-I and type-III fibrillar collagens has provided an important indicator of the progression of the healing process (Karu 2003; Gonçalves et al. 2010a,b2010b). In the earlier stages of cutaneous wound healing the synthesis of type-III collagen predominates and is then gradually replaced by type-I collagen fibres, thicker, resilient and the type of collagen that predominate in normal tissue (unharmed). Thus, determining the proportion of type-I collagen fibres in relation to type-III fibres allows us to evaluate the level of remodelling and maturation of scar tissue, which in turn indicates how much this tissue approximates to the tissue when it is unharmed (Reddy 2004; Mendez et al. 2004; Gonçalves et al. 2010b). Considering these characteristics, it is widely recognized that therapeutic approaches that stimulate the synthesis of type-I collagen, leading to increased collagen maturation, are potentially useful strategies in the treatment of skin injuries (Medrado et al. 2003; Pugliese et al. 2003; Gonçalves et al. 2010a,b2010b).

An additional result shown in the present study was the influence of the laser photobiostimulation on the glycosaminoglycan content in irradiated tissue. This finding indicates a transient modification of some structural polysaccharides of the extracellular matrix during the healing of skin wounds. It is believed that this event is possibly related to the development of a structural and functional support able to stimulate the cell migration and differentiation (Pierce et al. 1991; Hodde 2002; Lai et al. 2006). It is known that the content and distribution of polysaccharides molecules are important to the hydration (attraction of water molecules – solvation water) and nutrition of the granulation tissue during the development of a vascular network that would allow the progression of tissue repair (Pierce et al. 1991; Hodde 2002; Lai et al. 2006). Although the quantity and quality of non-protein and protein components of the stromal tissue are important in tissue repair, currently there is not sufficient evidence as to how the laser irradiation modulates the synthesis and secretion of polysaccharide molecules to stimulate the healing of skin wounds. As the analysis of these molecules performed in this study is not as sensitive and specific as some molecular biology techniques, we cannot yet establish how much the induction of synthesis of polysaccharides contributes to the mechanism through which the laser photobiostimulation improves the healing process. Thus, further studies are needed in this area.

In addition to the increased collagen and glycosaminoglycan content, the laser-treated groups also had a higher tissue area occupied by capillaries, with the best results in the group that received the highest energy density. Furthermore, this study confirmed previous findings (Moore et al. 2005; Houreld et al. 2010) that the laser radiation, in both low and high doses, stimulates the tissue cellularity and increases the synthesis of granulation tissue, which are aspects involved in tissue repair. These data are similar to those described by Corazza et al. (2007) and Gonçalves et al. (2010a). These authors showed the efficiency of high-energy dosages in the induction of fibroblast proliferation and neoangiogenesis. However, these findings are in contrast to previous studies that show better results in these variables with the use of low doses of energy, especially 1–4 J/cm2 (Tuner & Hode 1998; Medrado et al. 2003; Reddy 2004). A complex mechanism has been described through which the laser light stimulates the tissue repair. Studies with models of soft-tissue injuries have provided evidence that the photobiostimulation laser induces the synthesis and secretion of mitogens (Posten et al. 2005; Houreld et al. 2010; Xavier et al. 2010) such as vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), fibroblast growth factor (FGF) and tumour necrosis factor alpha (TNF-α) by macrophages, neutrophils, endothelial cells and fibroblasts, which stimulate the reorganization and repair of damaged tissue through the induction of proliferation, cell differentiation and neoangiogenesis (Posten et al. 2005; Houreld et al. 2010; Xavier et al. 2010).

There is sufficient evidence that the synthesis and differentiation of parenchymal and stromal components of the tissue determine the progression of the reorganization of injured tissue and the quality of the neoformed tissue (Karu 2003; Posten et al. 2005; Corazza et al. 2007; Liu et al. 2008). Thus, therapeutic interventions that stimulate the production of cellular and molecular components of the granulation tissue have been effective in promoting faster closure of wounds in soft tissues (Gonçalves et al. 2010a,b2010b; Xavier et al. 2010). In the present study, the group that received a higher dose of laser radiation (L30) showed more rapid progression of wound closure compared with other groups. These data are similar to those found by Enwemeka et al. (2004) and Moore et al. (2005), which showed the influence of various parameters of laser photobiostimulation on the tissue repair, including reduction in the wound area mainly with moderate energy densities between 19 and 24 J/cm2. In contrast, in these same studies, densities below 8.25 J/cm2 did not improve the injuries' closing time, findings that are contrary to the results of Medrado et al. (2003), Pugliese et al. (2003) and Mendez et al. (2004) that demonstrated a higher closing speed of the injured tissue at low energy densities (2–4 J/cm2), while high doses led to a delay in tissue recovery.

The findings of the present study suggest that laser photobiostimulation can modulate the process of skin wound healing in a time-dependent way. The higher energy density investigated was more effective in modifying the morphology of the parenchyma and stroma of the scar tissue and led to a faster healing. Considering the findings of this study in relation to the contradictory results of previous investigations, it is evident that additional studies are required to investigate the effects of photobiostimulation lasers with different energy densities on biological tissues, especially in relation to ultrastructural and metabolic changes of injured tissues.


Intro: This study investigates the influence of gallium-arsenide (GaAs) laser photobiostimulation applied with different energy densities on skin wound healing by secondary intention in rats. Three circular wounds, 10 mm in diameter, were made on the dorsolateral region of 21 Wistar rats weighting 282.12 ± 36.08 g. The animals were equally randomized into three groups: Group SAL, saline solution 0.9%; Group L3, laser GaAs 3 J/cm(2); Group L30, laser GaAs 30 J/cm(2). Analyses of cells, blood vessels, collagen and elastic fibres, glycosaminoglycans and wound contraction were performed on the scar tissue from different wounds every 7 days for 21 days. On day 7, 14 and 21, L3 and L30 showed higher collagen and glycosaminoglycan levels compared to SAL (P < 0.05). At day 21, elastic fibres were predominant in L3 and L30 compared to SAL (P < 0.05). Type-III collagen fibres were predominant at day 7 in both groups. There was gradual reduction in these fibres and accumulation of type-I collagen over time, especially in L3 and L30 compared with SAL. Elevated density of blood vessels was seen in L30 on days 7 and 14 compared to the other groups (P < 0.05). On these same days, there was higher tissue cellularity in L3 compared with SAL (P < 0.05). The progression of wound closure during all time points investigated was higher in the L30 group (P < 0.05). Both energy densities investigated increased the tissue cellularity, vascular density, collagen and elastic fibres, and glycosaminoglycan synthesis, with the greater benefits for wound closure being found at the density of 30 J/cm(2).

Background: This study investigates the influence of gallium-arsenide (GaAs) laser photobiostimulation applied with different energy densities on skin wound healing by secondary intention in rats. Three circular wounds, 10 mm in diameter, were made on the dorsolateral region of 21 Wistar rats weighting 282.12 ± 36.08 g. The animals were equally randomized into three groups: Group SAL, saline solution 0.9%; Group L3, laser GaAs 3 J/cm(2); Group L30, laser GaAs 30 J/cm(2). Analyses of cells, blood vessels, collagen and elastic fibres, glycosaminoglycans and wound contraction were performed on the scar tissue from different wounds every 7 days for 21 days. On day 7, 14 and 21, L3 and L30 showed higher collagen and glycosaminoglycan levels compared to SAL (P < 0.05). At day 21, elastic fibres were predominant in L3 and L30 compared to SAL (P < 0.05). Type-III collagen fibres were predominant at day 7 in both groups. There was gradual reduction in these fibres and accumulation of type-I collagen over time, especially in L3 and L30 compared with SAL. Elevated density of blood vessels was seen in L30 on days 7 and 14 compared to the other groups (P < 0.05). On these same days, there was higher tissue cellularity in L3 compared with SAL (P < 0.05). The progression of wound closure during all time points investigated was higher in the L30 group (P < 0.05). Both energy densities investigated increased the tissue cellularity, vascular density, collagen and elastic fibres, and glycosaminoglycan synthesis, with the greater benefits for wound closure being found at the density of 30 J/cm(2).

Abstract: Abstract This study investigates the influence of gallium-arsenide (GaAs) laser photobiostimulation applied with different energy densities on skin wound healing by secondary intention in rats. Three circular wounds, 10 mm in diameter, were made on the dorsolateral region of 21 Wistar rats weighting 282.12 ± 36.08 g. The animals were equally randomized into three groups: Group SAL, saline solution 0.9%; Group L3, laser GaAs 3 J/cm(2); Group L30, laser GaAs 30 J/cm(2). Analyses of cells, blood vessels, collagen and elastic fibres, glycosaminoglycans and wound contraction were performed on the scar tissue from different wounds every 7 days for 21 days. On day 7, 14 and 21, L3 and L30 showed higher collagen and glycosaminoglycan levels compared to SAL (P < 0.05). At day 21, elastic fibres were predominant in L3 and L30 compared to SAL (P < 0.05). Type-III collagen fibres were predominant at day 7 in both groups. There was gradual reduction in these fibres and accumulation of type-I collagen over time, especially in L3 and L30 compared with SAL. Elevated density of blood vessels was seen in L30 on days 7 and 14 compared to the other groups (P < 0.05). On these same days, there was higher tissue cellularity in L3 compared with SAL (P < 0.05). The progression of wound closure during all time points investigated was higher in the L30 group (P < 0.05). Both energy densities investigated increased the tissue cellularity, vascular density, collagen and elastic fibres, and glycosaminoglycan synthesis, with the greater benefits for wound closure being found at the density of 30 J/cm(2).

Methods: 2013 The Authors. International Journal of Experimental Pathology © 2013 International Journal of Experimental Pathology.

Conclusions: The present study investigated the effect of different energy densities of the GaAs laser on skin wound healing. Using design-based stereology and spectrophotometric methods, the results indicated that the laser photobiostimulation was able to modify the morphology of the scar tissue in a time-dependent way leading to more efficient healing. It is widely recognized that for healing to occur properly, synthesis of extracellular matrix is required, especially collagen, a protein that provides structural support for cell proliferation and neoangiogenesis (Liu et?al. 2008; Gonçalves et?al. 2010a,b2010b). The results of this study showed that both groups that received laser irradiation had a higher total collagen content at all time points analysed. These findings corroborate the results found by Medrado et?al. (2003) and Gonçalves et?al. (2010a,b2010b), which observed a significant increase in the collagen content in scar tissue 7?days after laser irradiation of skin wounds in rats. Collagen synthesis is an event directly related to the biomechanical properties of the scar tissue. In this context, the greatest collagen content gives the scar tissue greater resistance to mechanical stresses, a characteristic essential to the maintenance of tissue integrity and to reduced susceptibility to further injury (Karu 2003; Gonçalves et?al. 2010a,b2010b). Considering the different collagen types, both irradiated groups had a higher proportion of type-I and type-III collagen fibres than the control group. Both energy densities investigated were effective in stimulating the maturation of collagen in scar tissue, and the best results were found in group L30. Although laser irradiation has influenced the total levels of collagen, it is essential to identify the types of collagen produced in scar tissue. Traditionally, the assessment of type-I and type-III fibrillar collagens has provided an important indicator of the progression of the healing process (Karu 2003; Gonçalves et?al. 2010a,b2010b). In the earlier stages of cutaneous wound healing the synthesis of type-III collagen predominates and is then gradually replaced by type-I collagen fibres, thicker, resilient and the type of collagen that predominate in normal tissue (unharmed). Thus, determining the proportion of type-I collagen fibres in relation to type-III fibres allows us to evaluate the level of remodelling and maturation of scar tissue, which in turn indicates how much this tissue approximates to the tissue when it is unharmed (Reddy 2004; Mendez et?al. 2004; Gonçalves et?al. 2010b). Considering these characteristics, it is widely recognized that therapeutic approaches that stimulate the synthesis of type-I collagen, leading to increased collagen maturation, are potentially useful strategies in the treatment of skin injuries (Medrado et?al. 2003; Pugliese et?al. 2003; Gonçalves et?al. 2010a,b2010b). An additional result shown in the present study was the influence of the laser photobiostimulation on the glycosaminoglycan content in irradiated tissue. This finding indicates a transient modification of some structural polysaccharides of the extracellular matrix during the healing of skin wounds. It is believed that this event is possibly related to the development of a structural and functional support able to stimulate the cell migration and differentiation (Pierce et?al. 1991; Hodde 2002; Lai et?al. 2006). It is known that the content and distribution of polysaccharides molecules are important to the hydration (attraction of water molecules – solvation water) and nutrition of the granulation tissue during the development of a vascular network that would allow the progression of tissue repair (Pierce et?al. 1991; Hodde 2002; Lai et?al. 2006). Although the quantity and quality of non-protein and protein components of the stromal tissue are important in tissue repair, currently there is not sufficient evidence as to how the laser irradiation modulates the synthesis and secretion of polysaccharide molecules to stimulate the healing of skin wounds. As the analysis of these molecules performed in this study is not as sensitive and specific as some molecular biology techniques, we cannot yet establish how much the induction of synthesis of polysaccharides contributes to the mechanism through which the laser photobiostimulation improves the healing process. Thus, further studies are needed in this area. In addition to the increased collagen and glycosaminoglycan content, the laser-treated groups also had a higher tissue area occupied by capillaries, with the best results in the group that received the highest energy density. Furthermore, this study confirmed previous findings (Moore et?al. 2005; Houreld et?al. 2010) that the laser radiation, in both low and high doses, stimulates the tissue cellularity and increases the synthesis of granulation tissue, which are aspects involved in tissue repair. These data are similar to those described by Corazza et?al. (2007) and Gonçalves et?al. (2010a). These authors showed the efficiency of high-energy dosages in the induction of fibroblast proliferation and neoangiogenesis. However, these findings are in contrast to previous studies that show better results in these variables with the use of low doses of energy, especially 1–4?J/cm2 (Tuner & Hode 1998; Medrado et?al. 2003; Reddy 2004). A complex mechanism has been described through which the laser light stimulates the tissue repair. Studies with models of soft-tissue injuries have provided evidence that the photobiostimulation laser induces the synthesis and secretion of mitogens (Posten et?al. 2005; Houreld et?al. 2010; Xavier et?al. 2010) such as vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), fibroblast growth factor (FGF) and tumour necrosis factor alpha (TNF-?) by macrophages, neutrophils, endothelial cells and fibroblasts, which stimulate the reorganization and repair of damaged tissue through the induction of proliferation, cell differentiation and neoangiogenesis (Posten et?al. 2005; Houreld et?al. 2010; Xavier et?al. 2010). There is sufficient evidence that the synthesis and differentiation of parenchymal and stromal components of the tissue determine the progression of the reorganization of injured tissue and the quality of the neoformed tissue (Karu 2003; Posten et?al. 2005; Corazza et?al. 2007; Liu et?al. 2008). Thus, therapeutic interventions that stimulate the production of cellular and molecular components of the granulation tissue have been effective in promoting faster closure of wounds in soft tissues (Gonçalves et?al. 2010a,b2010b; Xavier et?al. 2010). In the present study, the group that received a higher dose of laser radiation (L30) showed more rapid progression of wound closure compared with other groups. These data are similar to those found by Enwemeka et?al. (2004) and Moore et?al. (2005), which showed the influence of various parameters of laser photobiostimulation on the tissue repair, including reduction in the wound area mainly with moderate energy densities between 19 and 24?J/cm2. In contrast, in these same studies, densities below 8.25?J/cm2 did not improve the injuries' closing time, findings that are contrary to the results of Medrado et?al. (2003), Pugliese et?al. (2003) and Mendez et?al. (2004) that demonstrated a higher closing speed of the injured tissue at low energy densities (2–4?J/cm2), while high doses led to a delay in tissue recovery. The findings of the present study suggest that laser photobiostimulation can modulate the process of skin wound healing in a time-dependent way. The higher energy density investigated was more effective in modifying the morphology of the parenchyma and stroma of the scar tissue and led to a faster healing. Considering the findings of this study in relation to the contradictory results of previous investigations, it is evident that additional studies are required to investigate the effects of photobiostimulation lasers with different energy densities on biological tissues, especially in relation to ultrastructural and metabolic changes of injured tissues.

Original Source: http://www.ncbi.nlm.nih.gov/pubmed/24354418

Effect of the 532nm pulsed KTP laser in the treatment of Reinke's edema.

Pitman MJ1, Lebowitz-Cooper A, Iacob C, Tan M. - Laryngoscope. 2012 Dec;122(12):2786-92. doi: 10.1002/lary.23576. Epub 2012 Aug 8. ()
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Intro: To evaluate the effect and safety of the 532nm Pulsed Potassium-Titanyl-Phosphate (KTP) laser in the office-based treatment of patients with Reinke's edema using objective and subjective scaled outcome measures.

Background: To evaluate the effect and safety of the 532nm Pulsed Potassium-Titanyl-Phosphate (KTP) laser in the office-based treatment of patients with Reinke's edema using objective and subjective scaled outcome measures.

Abstract: Abstract OBJECTIVES/HYPOTHESIS: To evaluate the effect and safety of the 532nm Pulsed Potassium-Titanyl-Phosphate (KTP) laser in the office-based treatment of patients with Reinke's edema using objective and subjective scaled outcome measures. STUDY DESIGN: Case Series. SETTING: Tertiary hospital center. SUBJECTS: Seven adult females undergoing in-office KTP laser treatment for Reinke's edema. METHODS: Participants were studied pre- and posttreatment. Vocal function was evaluated by objective aerodynamic and acoustic analysis. Subjective changes were evaluated using the GRBAS scale, Voice Handicap Index, and videostroboscopy. Histologic effects of the laser were investigated by comparing one patient treated with laser one year prior to excision, one treated with laser just prior to excision, and one control patient who underwent excision without prior laser treatment. RESULTS: At an average postoperative follow up of 17.8 weeks (range 5-78), maximum phonation time trended toward improvement. The median VHI score decreased from 37 to 26 (p=0.150). There was a reduction in each component of the GRBAS scoring and the median fundamental frequency increased from 162 to 186 (p=0.625). Stroboscopic findings demonstrated an intact posttreatment mucosal wave. Histologic comparison of the tissue effects of laser in three patients demonstrated changes in vocal fold vascularity but no acute or long-term damage to the overlying epithelium. CONCLUSION: Objective and subjective scaled measures suggest that treatment of Reinke's edema in the office with a 532nm KTP laser may result in improved voice. It appears safe with histologic preservation of the vocal fold vibratory epithelium and persistence of mucosal wave. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Methods: Case Series.

Results: Tertiary hospital center.

Conclusions: Seven adult females undergoing in-office KTP laser treatment for Reinke's edema.

Original Source: http://www.ncbi.nlm.nih.gov/pubmed/22886907

Photoactivation of bone marrow mesenchymal stromal cells with diode laser: effects and mechanisms of action.

Giannelli M1, Chellini F, Sassoli C, Francini F, Pini A, Squecco R, Nosi D, Bani D, Zecchi-Orlandini S, Formigli L. - J Cell Physiol. 2013 Jan;228(1):172-81. doi: 10.1002/jcp.24119. ()
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Intro: Mesenchymal stromal cells (MSCs) are a promising cell candidate in tissue engineering and regenerative medicine. Their proliferative potential can be increased by low-level laser irradiation (LLLI), but the mechanisms involved remain to be clarified. With the aim of expanding the therapeutic application of LLLI to MSC therapy, in the present study we investigated the effects of 635 nm diode laser on mouse MSC proliferation and investigated the underlying cellular and molecular mechanisms, focusing the attention on the effects of laser irradiation on Notch-1 signal activation and membrane ion channel modulation. It was found that MSC proliferation was significantly enhanced after laser irradiation, as judged by time lapse videomicroscopy and EdU incorporation. This phenomenon was associated with the up-regulation and activation of Notch-1 pathway, and with increased membrane conductance through voltage-gated K(+) , BK and Kir, channels and T- and L-type Ca(2+) channels. We also showed that MSC proliferation was mainly dependent on Kir channel activity, on the basis that the cell growth and Notch-1 up-regulation were severely decreased by the pre-treatment with the channel inhibitor Ba(2+) (0.5 mM). Interestingly, the channel inhibition was also able to attenuate the stimulatory effects of diode laser on MSCs, thus providing novel evidence to expand our knowledge on the mechanisms of biostimulation after LLLI. In conclusions, our findings suggest that diode laser may be a valid approach for the preconditioning of MSCs in vitro prior cell transplantation.

Background: Mesenchymal stromal cells (MSCs) are a promising cell candidate in tissue engineering and regenerative medicine. Their proliferative potential can be increased by low-level laser irradiation (LLLI), but the mechanisms involved remain to be clarified. With the aim of expanding the therapeutic application of LLLI to MSC therapy, in the present study we investigated the effects of 635 nm diode laser on mouse MSC proliferation and investigated the underlying cellular and molecular mechanisms, focusing the attention on the effects of laser irradiation on Notch-1 signal activation and membrane ion channel modulation. It was found that MSC proliferation was significantly enhanced after laser irradiation, as judged by time lapse videomicroscopy and EdU incorporation. This phenomenon was associated with the up-regulation and activation of Notch-1 pathway, and with increased membrane conductance through voltage-gated K(+) , BK and Kir, channels and T- and L-type Ca(2+) channels. We also showed that MSC proliferation was mainly dependent on Kir channel activity, on the basis that the cell growth and Notch-1 up-regulation were severely decreased by the pre-treatment with the channel inhibitor Ba(2+) (0.5 mM). Interestingly, the channel inhibition was also able to attenuate the stimulatory effects of diode laser on MSCs, thus providing novel evidence to expand our knowledge on the mechanisms of biostimulation after LLLI. In conclusions, our findings suggest that diode laser may be a valid approach for the preconditioning of MSCs in vitro prior cell transplantation.

Abstract: Abstract Mesenchymal stromal cells (MSCs) are a promising cell candidate in tissue engineering and regenerative medicine. Their proliferative potential can be increased by low-level laser irradiation (LLLI), but the mechanisms involved remain to be clarified. With the aim of expanding the therapeutic application of LLLI to MSC therapy, in the present study we investigated the effects of 635 nm diode laser on mouse MSC proliferation and investigated the underlying cellular and molecular mechanisms, focusing the attention on the effects of laser irradiation on Notch-1 signal activation and membrane ion channel modulation. It was found that MSC proliferation was significantly enhanced after laser irradiation, as judged by time lapse videomicroscopy and EdU incorporation. This phenomenon was associated with the up-regulation and activation of Notch-1 pathway, and with increased membrane conductance through voltage-gated K(+) , BK and Kir, channels and T- and L-type Ca(2+) channels. We also showed that MSC proliferation was mainly dependent on Kir channel activity, on the basis that the cell growth and Notch-1 up-regulation were severely decreased by the pre-treatment with the channel inhibitor Ba(2+) (0.5 mM). Interestingly, the channel inhibition was also able to attenuate the stimulatory effects of diode laser on MSCs, thus providing novel evidence to expand our knowledge on the mechanisms of biostimulation after LLLI. In conclusions, our findings suggest that diode laser may be a valid approach for the preconditioning of MSCs in vitro prior cell transplantation. Copyright © 2012 Wiley Periodicals, Inc.

Methods: Copyright © 2012 Wiley Periodicals, Inc.

Original Source: http://www.ncbi.nlm.nih.gov/pubmed/22628164

In vivo microscopic approaches for facial melanocytic lesions after quality-switched ruby laser therapy: time-sequential imaging of melanin and melanocytes of solar lentigo in Asian skin.

Yamashita T1, Negishi K, Hariya T, Yanai M, Iikura T, Wakamatsu S. - Dermatol Surg. 2010 Jul;36(7):1138-47. doi: 10.1111/j.1524-4725.2010.01598.x. ()
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Intro: The quality-switched ruby laser (QSRL) has been widely used for the treatment of pigmented lesions, but clinical evaluations in most studies have been conducted on macroscopic skin color observation comparing the laser-treated skin with its nontreated surrounding area. A few investigations examined skin changes after laser therapy at a cellular level, but almost none did so noninvasively.

Background: The quality-switched ruby laser (QSRL) has been widely used for the treatment of pigmented lesions, but clinical evaluations in most studies have been conducted on macroscopic skin color observation comparing the laser-treated skin with its nontreated surrounding area. A few investigations examined skin changes after laser therapy at a cellular level, but almost none did so noninvasively.

Abstract: Abstract BACKGROUND: The quality-switched ruby laser (QSRL) has been widely used for the treatment of pigmented lesions, but clinical evaluations in most studies have been conducted on macroscopic skin color observation comparing the laser-treated skin with its nontreated surrounding area. A few investigations examined skin changes after laser therapy at a cellular level, but almost none did so noninvasively. OBJECTIVE: To elucidate the dynamic changes after QSRL irradiation of facial solar lentigo using noninvasive optical techniques. MATERIALS AND METHODS: Time-sequential imaging of Japanese female patients with a clinical diagnosis of solar lentigo was performed using ultraviolet photography, high-magnification videomicroscopy, and reflectance-mode confocal microscopy to examine pigmentary change after QSRL irradiation. RESULTS: The present study showed that remaining melanocytes were visible in the solar lentigo of all subjects when crusts peeled off, despite hardly observable skin pigmentation to the naked eye. Moreover, noninvasive confocal imaging revealed that pigmented melanocytes varied in each solar lentigo after QSRL treatment, as indicated by melanin reflection level. CONCLUSIONS: Optical techniques facilitate the evaluation of the in vivo dynamics of epidermal-melanocytic changes in solar lentigo after QSRL therapy and may be useful for monitoring outcomes after laser irradiation.

Methods: To elucidate the dynamic changes after QSRL irradiation of facial solar lentigo using noninvasive optical techniques.

Results: Time-sequential imaging of Japanese female patients with a clinical diagnosis of solar lentigo was performed using ultraviolet photography, high-magnification videomicroscopy, and reflectance-mode confocal microscopy to examine pigmentary change after QSRL irradiation.

Conclusions: The present study showed that remaining melanocytes were visible in the solar lentigo of all subjects when crusts peeled off, despite hardly observable skin pigmentation to the naked eye. Moreover, noninvasive confocal imaging revealed that pigmented melanocytes varied in each solar lentigo after QSRL treatment, as indicated by melanin reflection level.

Original Source: http://www.ncbi.nlm.nih.gov/pubmed/20653729

In vivo microscopic approaches for facial melanocytic lesions after quality-switched ruby laser therapy: time-sequential imaging of melanin and melanocytes of solar lentigo in Asian skin.

Yamashita T1, Negishi K, Hariya T, Yanai M, Iikura T, Wakamatsu S. - Dermatol Surg. 2010 Jul;36(7):1138-47. doi: 10.1111/j.1524-4725.2010.01598.x. ()
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Intro: The quality-switched ruby laser (QSRL) has been widely used for the treatment of pigmented lesions, but clinical evaluations in most studies have been conducted on macroscopic skin color observation comparing the laser-treated skin with its nontreated surrounding area. A few investigations examined skin changes after laser therapy at a cellular level, but almost none did so noninvasively.

Background: The quality-switched ruby laser (QSRL) has been widely used for the treatment of pigmented lesions, but clinical evaluations in most studies have been conducted on macroscopic skin color observation comparing the laser-treated skin with its nontreated surrounding area. A few investigations examined skin changes after laser therapy at a cellular level, but almost none did so noninvasively.

Abstract: Abstract BACKGROUND: The quality-switched ruby laser (QSRL) has been widely used for the treatment of pigmented lesions, but clinical evaluations in most studies have been conducted on macroscopic skin color observation comparing the laser-treated skin with its nontreated surrounding area. A few investigations examined skin changes after laser therapy at a cellular level, but almost none did so noninvasively. OBJECTIVE: To elucidate the dynamic changes after QSRL irradiation of facial solar lentigo using noninvasive optical techniques. MATERIALS AND METHODS: Time-sequential imaging of Japanese female patients with a clinical diagnosis of solar lentigo was performed using ultraviolet photography, high-magnification videomicroscopy, and reflectance-mode confocal microscopy to examine pigmentary change after QSRL irradiation. RESULTS: The present study showed that remaining melanocytes were visible in the solar lentigo of all subjects when crusts peeled off, despite hardly observable skin pigmentation to the naked eye. Moreover, noninvasive confocal imaging revealed that pigmented melanocytes varied in each solar lentigo after QSRL treatment, as indicated by melanin reflection level. CONCLUSIONS: Optical techniques facilitate the evaluation of the in vivo dynamics of epidermal-melanocytic changes in solar lentigo after QSRL therapy and may be useful for monitoring outcomes after laser irradiation.

Methods: To elucidate the dynamic changes after QSRL irradiation of facial solar lentigo using noninvasive optical techniques.

Results: Time-sequential imaging of Japanese female patients with a clinical diagnosis of solar lentigo was performed using ultraviolet photography, high-magnification videomicroscopy, and reflectance-mode confocal microscopy to examine pigmentary change after QSRL irradiation.

Conclusions: The present study showed that remaining melanocytes were visible in the solar lentigo of all subjects when crusts peeled off, despite hardly observable skin pigmentation to the naked eye. Moreover, noninvasive confocal imaging revealed that pigmented melanocytes varied in each solar lentigo after QSRL treatment, as indicated by melanin reflection level.

Original Source: http://www.ncbi.nlm.nih.gov/pubmed/20653729

Treatment of striae distensae with a TriPollar radiofrequency device: a pilot study.

Manuskiatti W1, Boonthaweeyuwat E, Varothai S. - J Dermatolog Treat. 2009;20(6):359-64. doi: 10.3109/09546630903085278. ()
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Intro: Striae distensae are a frequent skin condition for which treatment remains a challenge.

Background: Striae distensae are a frequent skin condition for which treatment remains a challenge.

Abstract: Abstract BACKGROUND: Striae distensae are a frequent skin condition for which treatment remains a challenge. OBJECTIVES: To determine the efficacy and safety of a TriPollar radiofrequency (RF) device for the treatment of striae in skin phototypes IV-V. METHODS: Seventeen females with striae received six weekly treatments with a TriPollar RF device. The participants were evaluated using standardized photographs and a UVA-light video camera at baseline, and at 1 and 6 weeks after the final treatment. Side effects of treatment were recorded at every session. RESULTS: At 1 week after the final treatment, 38.2% and 11.8% of the subjects were assessed to have 25-50% and 51-75% improvement of their striae, respectively. Compared with the 1-week follow-up, at the 6-week follow-up a higher percentage of the subjects were rated to have improvement of their striae. There were no significant differences in the striae surface smoothness at the 1- (p = 0.907) and 6-week (p = 0.057) follow-ups, compared with that of baseline. Twelve percent (2/17), 23% (4/17), and 65% (11/17) of the study subjects rated their satisfaction of the overall improvement as slightly satisfied, satisfied, and very satisfied, respectively. No adverse effect was reported. CONCLUSION: TriPollar RF appears to be a promising alternative for the treatment of striae distensae.

Methods: To determine the efficacy and safety of a TriPollar radiofrequency (RF) device for the treatment of striae in skin phototypes IV-V.

Results: Seventeen females with striae received six weekly treatments with a TriPollar RF device. The participants were evaluated using standardized photographs and a UVA-light video camera at baseline, and at 1 and 6 weeks after the final treatment. Side effects of treatment were recorded at every session.

Conclusions: At 1 week after the final treatment, 38.2% and 11.8% of the subjects were assessed to have 25-50% and 51-75% improvement of their striae, respectively. Compared with the 1-week follow-up, at the 6-week follow-up a higher percentage of the subjects were rated to have improvement of their striae. There were no significant differences in the striae surface smoothness at the 1- (p = 0.907) and 6-week (p = 0.057) follow-ups, compared with that of baseline. Twelve percent (2/17), 23% (4/17), and 65% (11/17) of the study subjects rated their satisfaction of the overall improvement as slightly satisfied, satisfied, and very satisfied, respectively. No adverse effect was reported.

Original Source: http://www.ncbi.nlm.nih.gov/pubmed/19954393

The use of low-level light for hair growth: part I.

Avram MR1, Rogers NE. - J Cosmet Laser Ther. 2009 Jun;11(2):110-7. doi: 10.1080/14764170902842531. ()
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Intro: Low-level laser therapy (LLLT) is a new therapy for the treatment of hair loss. It has received enormous media attention and tremendous marketing budgets from companies that sell the devices, but no independent, peer-reviewed studies have demonstrated its efficacy in this application. Here we investigate the efficacy of LLLT in enhancing hair growth.

Background: Low-level laser therapy (LLLT) is a new therapy for the treatment of hair loss. It has received enormous media attention and tremendous marketing budgets from companies that sell the devices, but no independent, peer-reviewed studies have demonstrated its efficacy in this application. Here we investigate the efficacy of LLLT in enhancing hair growth.

Abstract: Abstract BACKGROUND AND OBJECTIVE: Low-level laser therapy (LLLT) is a new therapy for the treatment of hair loss. It has received enormous media attention and tremendous marketing budgets from companies that sell the devices, but no independent, peer-reviewed studies have demonstrated its efficacy in this application. Here we investigate the efficacy of LLLT in enhancing hair growth. METHODS: A total of seven patients were exposed to LLLT twice weekly for 20 minutes each time over a period of 3-6 months. Five patients were treated for a total of 3 months and two were treated for 6 months. Videomicroscopic images were taken at baseline, 3 months, and 6 months, and analyzed for changes in vellus hair counts, terminal hair counts, and shaft diameter. Both videomicroscopic and global images underwent blinded review for evidence of subjective improvement. Patients also answered questionnaires assessing hair growth throughout the study. Neither patients nor physicians conducting the study received any financial compensation. RESULTS: The results indicate that on average patients had a decrease in the number of vellus hairs, an increase in the number of terminal hairs, and an increase in shaft diameter. However, paired i-testing indicated that none of these changes was statistically significant. Also, blinded evaluation of global images did not support an improvement in hair density or caliber. CONCLUSIONS: LLLT may be a promising treatment option for patients who do not respond to either finasteride or minoxidil, and who do not want to undergo hair transplantation. This technology appears to work better for some people than for others. Factors predicting who will most benefit are yet to be determined. Larger, longer-term placebo-controlled studies are needed to confirm these findings, and demonstrate statistical significance, or refute them altogether.

Methods: A total of seven patients were exposed to LLLT twice weekly for 20 minutes each time over a period of 3-6 months. Five patients were treated for a total of 3 months and two were treated for 6 months. Videomicroscopic images were taken at baseline, 3 months, and 6 months, and analyzed for changes in vellus hair counts, terminal hair counts, and shaft diameter. Both videomicroscopic and global images underwent blinded review for evidence of subjective improvement. Patients also answered questionnaires assessing hair growth throughout the study. Neither patients nor physicians conducting the study received any financial compensation.

Results: The results indicate that on average patients had a decrease in the number of vellus hairs, an increase in the number of terminal hairs, and an increase in shaft diameter. However, paired i-testing indicated that none of these changes was statistically significant. Also, blinded evaluation of global images did not support an improvement in hair density or caliber.

Conclusions: LLLT may be a promising treatment option for patients who do not respond to either finasteride or minoxidil, and who do not want to undergo hair transplantation. This technology appears to work better for some people than for others. Factors predicting who will most benefit are yet to be determined. Larger, longer-term placebo-controlled studies are needed to confirm these findings, and demonstrate statistical significance, or refute them altogether.

Original Source: http://www.ncbi.nlm.nih.gov/pubmed/19466643

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 EL1, Carragee EJ, van der Velde G, Carroll LJ, Nordin M, Guzman J, Peloso PM, Holm LW, Côté P, Hogg-Johnson S, Cassidy JD, Haldeman S. - J Manipulative Physiol Ther. 2009 Feb;32(2 Suppl):S141-75. doi: 10.1016/j.jmpt.2008.11.017. ()
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Intro: Best evidence synthesis.

Background: Best evidence synthesis.

Abstract: Abstract 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.

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

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

Conclusions: 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.

Original Source: http://www.ncbi.nlm.nih.gov/pubmed/19251061

Cold Laser Therapy for Pain and Sports Injuries

- 2011 (Video)
Demonstration of LLLT being used on a patient with a sports injury.
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 Demonstration of LLLT being used on a patient with a sports injury.

video length: (6:57)


Original Source: https://www.youtube.com/watch?v=mcZwYjAt7Jk

Visualising the procedures in the influence of water on the ablation of dental hard tissue with erbium:yttrium-aluminium-garnet and erbium, chromium:yttrium-scandium-gallium-garnet laser pulses.

Mir M1, Gutknecht N, Poprawe R, Vanweersch L, Lampert F. - Lasers Med Sci. 2009 May;24(3):365-74. doi: 10.1007/s10103-008-0571-1. Epub 2008 Jul 25. ()
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Intro: The exact mechanism of the ablation of tooth hard tissue with most common wavelengths, which are 2,940 nm and 2,780 nm, is not yet clear. There are several different theories, but none of them has yet been established. Concepts and methods of looking at these mechanisms have been based on heat formation and transformation, and mathematical calculations evaluating the outcome of ablation, such as looking at the shape of cuts. This study provides a new concept, which is the monitoring of the direct interactions between laser light, water and enamel, with a high-speed camera. For this purpose, both the above-mentioned wavelengths were examined. Bovine anterior teeth were prepared as thin slices. Each imaged slice had a thickness close to that of the beam diameter so that the ablation effect could be shown in two dimensional pictures. The single images were extracted from the video-clips and then were animated. The following steps, explaining the ablation procedures during each pulse, were seen and reported: (1) low-output energy intensity in the first pulses that did not lead to an ablative effect; (2) bubble formation with higher output energy density; (3) the tooth surface during the pulse was covered with the plume of vapour (comparable with a cloud), and the margins of ablation on the tooth were not clear; (4) when the vapour bubble (cloud) was collapsing, an additional ablative process at the surface could be seen.

Background: The exact mechanism of the ablation of tooth hard tissue with most common wavelengths, which are 2,940 nm and 2,780 nm, is not yet clear. There are several different theories, but none of them has yet been established. Concepts and methods of looking at these mechanisms have been based on heat formation and transformation, and mathematical calculations evaluating the outcome of ablation, such as looking at the shape of cuts. This study provides a new concept, which is the monitoring of the direct interactions between laser light, water and enamel, with a high-speed camera. For this purpose, both the above-mentioned wavelengths were examined. Bovine anterior teeth were prepared as thin slices. Each imaged slice had a thickness close to that of the beam diameter so that the ablation effect could be shown in two dimensional pictures. The single images were extracted from the video-clips and then were animated. The following steps, explaining the ablation procedures during each pulse, were seen and reported: (1) low-output energy intensity in the first pulses that did not lead to an ablative effect; (2) bubble formation with higher output energy density; (3) the tooth surface during the pulse was covered with the plume of vapour (comparable with a cloud), and the margins of ablation on the tooth were not clear; (4) when the vapour bubble (cloud) was collapsing, an additional ablative process at the surface could be seen.

Abstract: Abstract The exact mechanism of the ablation of tooth hard tissue with most common wavelengths, which are 2,940 nm and 2,780 nm, is not yet clear. There are several different theories, but none of them has yet been established. Concepts and methods of looking at these mechanisms have been based on heat formation and transformation, and mathematical calculations evaluating the outcome of ablation, such as looking at the shape of cuts. This study provides a new concept, which is the monitoring of the direct interactions between laser light, water and enamel, with a high-speed camera. For this purpose, both the above-mentioned wavelengths were examined. Bovine anterior teeth were prepared as thin slices. Each imaged slice had a thickness close to that of the beam diameter so that the ablation effect could be shown in two dimensional pictures. The single images were extracted from the video-clips and then were animated. The following steps, explaining the ablation procedures during each pulse, were seen and reported: (1) low-output energy intensity in the first pulses that did not lead to an ablative effect; (2) bubble formation with higher output energy density; (3) the tooth surface during the pulse was covered with the plume of vapour (comparable with a cloud), and the margins of ablation on the tooth were not clear; (4) when the vapour bubble (cloud) was collapsing, an additional ablative process at the surface could be seen.

Original Source: http://www.ncbi.nlm.nih.gov/pubmed/18654826

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 EL1, Carragee EJ, van der Velde G, Carroll LJ, Nordin M, Guzman J, Peloso PM, Holm LW, Côté P, Hogg-Johnson S, Cassidy JD, Haldeman S; Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. - Spine (Phila Pa 1976). 2008 Feb 15;33(4 Suppl):S123-52. doi: 10.1097/BRS.0b013e3181644b1d. ()
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Intro: Best evidence synthesis.

Background: Best evidence synthesis.

Abstract: Abstract 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.

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

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

Conclusions: 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.

Original Source: http://www.ncbi.nlm.nih.gov/pubmed/18204386

Laser surgery of port wine stains using local vacuum pressure: changes in skin morphology and optical properties (Part I).

Childers MA1, Franco W, Nelson JS, Aguilar G. - Lasers Surg Med. 2007 Feb;39(2):108-17. ()
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Intro: In a recent case study, the use of a suction device to aid in port wine stain (PWS) laser treatments showed favorable results. It is our objective to further understand the mechanisms of vacuum-assisted laser therapy by analyzing the mechanical and optical changes of the skin and musculoskeletal tissues during the application of mild vacuum pressure from a suction cup.

Background: In a recent case study, the use of a suction device to aid in port wine stain (PWS) laser treatments showed favorable results. It is our objective to further understand the mechanisms of vacuum-assisted laser therapy by analyzing the mechanical and optical changes of the skin and musculoskeletal tissues during the application of mild vacuum pressure from a suction cup.

Abstract: Abstract BACKGROUND AND OBJECTIVES: In a recent case study, the use of a suction device to aid in port wine stain (PWS) laser treatments showed favorable results. It is our objective to further understand the mechanisms of vacuum-assisted laser therapy by analyzing the mechanical and optical changes of the skin and musculoskeletal tissues during the application of mild vacuum pressure from a suction cup. STUDY DESIGN/MATERIALS AND METHODS: A mathematical model of tissue deformation was used to determine the changes in tissue morphology that affect the underlying laser-tissue interactions, such as epidermal stretching and thinning, blood vessel dilation, and change in blood vessel depth. Video imaging experiments were used to verify the bulk tissue deformation and skin surface stretching computed by the mathematical model. Additionally, visible reflectance spectroscopy was used to determine the changes in the optical characteristics of tissue, including blood vessel dilation and epidermal absorption coefficient. RESULTS: At a vacuum pressure of 50 kP(a), the epidermis at the center of the suction cup was measured to stretch 4% and was calculated to be thinned approximately 6%. Blood vessels embedded in the dermis were measured to dilate up to two times their original size. However, these vessels were calculated to be displaced toward the skin surface by a very small amount, approximately 1-3 microm. The absorption coefficient of the epidermis was also measured to be reduced significantly by approximately 25% at a wavelength of 585 nm. CONCLUSIONS: Mild vacuum pressure applied to the skin surface causes considerable changes in the morphology and optical properties of the tissue. These changes may be used for more efficient photothermolysis of small PWS blood vessels. (c) 2007 Wiley-Liss, Inc.

Methods: A mathematical model of tissue deformation was used to determine the changes in tissue morphology that affect the underlying laser-tissue interactions, such as epidermal stretching and thinning, blood vessel dilation, and change in blood vessel depth. Video imaging experiments were used to verify the bulk tissue deformation and skin surface stretching computed by the mathematical model. Additionally, visible reflectance spectroscopy was used to determine the changes in the optical characteristics of tissue, including blood vessel dilation and epidermal absorption coefficient.

Results: At a vacuum pressure of 50 kP(a), the epidermis at the center of the suction cup was measured to stretch 4% and was calculated to be thinned approximately 6%. Blood vessels embedded in the dermis were measured to dilate up to two times their original size. However, these vessels were calculated to be displaced toward the skin surface by a very small amount, approximately 1-3 microm. The absorption coefficient of the epidermis was also measured to be reduced significantly by approximately 25% at a wavelength of 585 nm.

Conclusions: Mild vacuum pressure applied to the skin surface causes considerable changes in the morphology and optical properties of the tissue. These changes may be used for more efficient photothermolysis of small PWS blood vessels.

Original Source: http://www.ncbi.nlm.nih.gov/pubmed/17311268

Holmium:YAG laser treatment of ureteral calculi: A 5-year experience.

Farkas A1, Péteri L, Lorincz L, Salah MA, Flaskó T, Varga A, Tóth C. - Lasers Med Sci. 2006 Sep;21(3):170-4. Epub 2006 Aug 1. ()
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Intro: The purpose of this study was to provide an account of the 5-year experience we have gained using holmium:yttrium-aluminium-garnet (Ho:YAG) lasertripsy in the treatment of ureteral stones. One-hundred thirty-seven transurethral ureterolithotripsies were performed in 131 patients. A Ho:YAG laser device, fibres with diameters of 360 and 550 mum, a video camera as well as semi-rigid and flexible ureterorenoscopes were used. Results showed that the direct success rates-which meant stone-free ureters on the first post-operative day-in the upper, middle and lower ureters were 84.6, 88.7 and 94.8%, respectively. The final success rates--which meant stone-free ureters 4 weeks after the operation without a second intervention--were 84.6, 96.7 and 96.7%, respectively. The pulsatile Ho:YAG laser beam fragmented all kinds of stones easily. No ureteral stricture or reflux was identified during the follow-up period. The advantages of Ho lasertripsy outweighed its disadvantages. Based on our experience, the Ho:YAG laser is one of the most effective and safest energy sources in the treatment of ureteral calculi.

Background: The purpose of this study was to provide an account of the 5-year experience we have gained using holmium:yttrium-aluminium-garnet (Ho:YAG) lasertripsy in the treatment of ureteral stones. One-hundred thirty-seven transurethral ureterolithotripsies were performed in 131 patients. A Ho:YAG laser device, fibres with diameters of 360 and 550 mum, a video camera as well as semi-rigid and flexible ureterorenoscopes were used. Results showed that the direct success rates-which meant stone-free ureters on the first post-operative day-in the upper, middle and lower ureters were 84.6, 88.7 and 94.8%, respectively. The final success rates--which meant stone-free ureters 4 weeks after the operation without a second intervention--were 84.6, 96.7 and 96.7%, respectively. The pulsatile Ho:YAG laser beam fragmented all kinds of stones easily. No ureteral stricture or reflux was identified during the follow-up period. The advantages of Ho lasertripsy outweighed its disadvantages. Based on our experience, the Ho:YAG laser is one of the most effective and safest energy sources in the treatment of ureteral calculi.

Abstract: Abstract The purpose of this study was to provide an account of the 5-year experience we have gained using holmium:yttrium-aluminium-garnet (Ho:YAG) lasertripsy in the treatment of ureteral stones. One-hundred thirty-seven transurethral ureterolithotripsies were performed in 131 patients. A Ho:YAG laser device, fibres with diameters of 360 and 550 mum, a video camera as well as semi-rigid and flexible ureterorenoscopes were used. Results showed that the direct success rates-which meant stone-free ureters on the first post-operative day-in the upper, middle and lower ureters were 84.6, 88.7 and 94.8%, respectively. The final success rates--which meant stone-free ureters 4 weeks after the operation without a second intervention--were 84.6, 96.7 and 96.7%, respectively. The pulsatile Ho:YAG laser beam fragmented all kinds of stones easily. No ureteral stricture or reflux was identified during the follow-up period. The advantages of Ho lasertripsy outweighed its disadvantages. Based on our experience, the Ho:YAG laser is one of the most effective and safest energy sources in the treatment of ureteral calculi.

Original Source: http://www.ncbi.nlm.nih.gov/pubmed/16897107

Effect of In-Ga-Al-P diode laser irradiation on angiogenesis in partial ruptures of Achilles tendon in rats.

Salate AC1, Barbosa G, Gaspar P, Koeke PU, Parizotto NA, Benze BG, Foschiani D. - Photomed Laser Surg. 2005 Oct;23(5):470-5. ()
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Intro: This study was conducted to analyze the effect of different irradiances of low-level laser therapy (LLLT) on angiogenesis after partial rupture of Achilles tendon of rats.

Background: This study was conducted to analyze the effect of different irradiances of low-level laser therapy (LLLT) on angiogenesis after partial rupture of Achilles tendon of rats.

Abstract: Abstract OBJECTIVE: This study was conducted to analyze the effect of different irradiances of low-level laser therapy (LLLT) on angiogenesis after partial rupture of Achilles tendon of rats. BACKGROUND DATA: METHODS: Ninety-six animals were divided into three groups subject to treatment during 3, 5, and 7 days post-lesion. Thirty-two animals were used in each group. The groups were further divided into four subgroups with eight animals in each, receiving In-Ga-Al-P laser (660 nm) treatment at (1) mean output of 10 mW, (2) 40 mW during 10 sec, (3) a sham subgroup, and (4) a non-treatment subgroup. Each animal was subjected to a lesion of the Achilles tendon by dropping a 186-g weight from a 20-cm height over the tendon. Treatment was initiated 6 h post-injury for all the groups. Blood vessels were colored with India ink injection and were examined in a video microscope. RESULTS: Laser exposure promoted an increase in blood vessel count when compared to controls. The 40-mW group showed early neovascularization, with the greatest number of microvessels after three laser applications. The 10-mW subgroup showed angiogenesis activity around the same time as the sham laser group did, but the net number of vessels was significantly higher in the former than in the controls. After seven irradiations, the subgroup receiving 40 mW experienced a drop in microvessel number, but it was still higher than in the control groups. CONCLUSIONS: LLLT of different intensities seems to promote neovascularization in damaged Achilles tendons of rats after partial rupture compared to controls.

Results: Ninety-six animals were divided into three groups subject to treatment during 3, 5, and 7 days post-lesion. Thirty-two animals were used in each group. The groups were further divided into four subgroups with eight animals in each, receiving In-Ga-Al-P laser (660 nm) treatment at (1) mean output of 10 mW, (2) 40 mW during 10 sec, (3) a sham subgroup, and (4) a non-treatment subgroup. Each animal was subjected to a lesion of the Achilles tendon by dropping a 186-g weight from a 20-cm height over the tendon. Treatment was initiated 6 h post-injury for all the groups. Blood vessels were colored with India ink injection and were examined in a video microscope.

Conclusions: Laser exposure promoted an increase in blood vessel count when compared to controls. The 40-mW group showed early neovascularization, with the greatest number of microvessels after three laser applications. The 10-mW subgroup showed angiogenesis activity around the same time as the sham laser group did, but the net number of vessels was significantly higher in the former than in the controls. After seven irradiations, the subgroup receiving 40 mW experienced a drop in microvessel number, but it was still higher than in the control groups.

Original Source: http://www.ncbi.nlm.nih.gov/pubmed/16262576

Effects of hypobaric pressure on human skin: implications for cryogen spray cooling (part II).

Aguilar G1, Franco W, Liu J, Svaasand LO, Nelson JS. - Lasers Surg Med. 2005 Feb;36(2):130-5. ()
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Intro: Clinical results have demonstrated that dark purple port wine stain (PWS) birthmarks respond favorably to laser induced photothermolysis after the first three to five treatments. Nevertheless, complete blanching is rarely achieved and the lesions stabilize at a red-pink color. In a feasibility study (Part I), we showed that local hypobaric pressure on PWS human skin prior to laser irradiation induced significant lesion blanching. The objective of the present study (Part II) is to investigate the effects of hypobaric pressures on the efficiency of cryogen spray cooling (CSC), a technique that assists laser therapy of PWS and other dermatoses.

Background: Clinical results have demonstrated that dark purple port wine stain (PWS) birthmarks respond favorably to laser induced photothermolysis after the first three to five treatments. Nevertheless, complete blanching is rarely achieved and the lesions stabilize at a red-pink color. In a feasibility study (Part I), we showed that local hypobaric pressure on PWS human skin prior to laser irradiation induced significant lesion blanching. The objective of the present study (Part II) is to investigate the effects of hypobaric pressures on the efficiency of cryogen spray cooling (CSC), a technique that assists laser therapy of PWS and other dermatoses.

Abstract: Abstract BACKGROUND AND OBJECTIVES: Clinical results have demonstrated that dark purple port wine stain (PWS) birthmarks respond favorably to laser induced photothermolysis after the first three to five treatments. Nevertheless, complete blanching is rarely achieved and the lesions stabilize at a red-pink color. In a feasibility study (Part I), we showed that local hypobaric pressure on PWS human skin prior to laser irradiation induced significant lesion blanching. The objective of the present study (Part II) is to investigate the effects of hypobaric pressures on the efficiency of cryogen spray cooling (CSC), a technique that assists laser therapy of PWS and other dermatoses. STUDY DESIGN/MATERIALS AND METHODS: Experiments were carried out within a suction cup and vacuum chamber to study the effect of hypobaric pressure on the: (1) interaction of cryogen sprays with human skin; (2) spray atomization; and (3) thermal response of a model skin phantom. A high-speed camera was used to acquire digital images of spray impingement on in vivo human skin and spray cones generated at different hypobaric pressures. Subsequently, liquid cryogen was sprayed onto a skin phantom at atmospheric and 17, 34, 51, and 68 kPa (5, 10, 15, and 20 in Hg) hypobaric pressures. A fast-response temperature sensor measured sub-surface phantom temperature as a function of time. Measurements were used to solve an inverse heat conduction problem to calculate surface temperatures, heat flux, and overall heat extraction at the skin phantom surface. RESULTS: Under hypobaric pressures, cryogen spurts did not produce skin indentation and only minimal frost formation. Sprays also showed shorter jet lengths and better atomization. Lower minimum surface temperatures and higher overall heat extraction from skin phantoms were reached. CONCLUSIONS: The combined effects of hypobaric pressure result in more efficient cryogen evaporation that enhances heat extraction and, therefore, improves the epidermal protection provided by CSC. (c) 2005 Wiley-Liss, Inc.

Methods: Experiments were carried out within a suction cup and vacuum chamber to study the effect of hypobaric pressure on the: (1) interaction of cryogen sprays with human skin; (2) spray atomization; and (3) thermal response of a model skin phantom. A high-speed camera was used to acquire digital images of spray impingement on in vivo human skin and spray cones generated at different hypobaric pressures. Subsequently, liquid cryogen was sprayed onto a skin phantom at atmospheric and 17, 34, 51, and 68 kPa (5, 10, 15, and 20 in Hg) hypobaric pressures. A fast-response temperature sensor measured sub-surface phantom temperature as a function of time. Measurements were used to solve an inverse heat conduction problem to calculate surface temperatures, heat flux, and overall heat extraction at the skin phantom surface.

Results: Under hypobaric pressures, cryogen spurts did not produce skin indentation and only minimal frost formation. Sprays also showed shorter jet lengths and better atomization. Lower minimum surface temperatures and higher overall heat extraction from skin phantoms were reached.

Conclusions: The combined effects of hypobaric pressure result in more efficient cryogen evaporation that enhances heat extraction and, therefore, improves the epidermal protection provided by CSC.

Original Source: http://www.ncbi.nlm.nih.gov/pubmed/15704166

Combined photodynamic and photothermal induced injury enhances damage to in vivo model blood vessels.

Kelly KM1, Kimel S, Smith T, Stacy A, Hammer-Wilson MJ, Svaasand LO, Nelson JS. - Lasers Surg Med. 2004;34(5):407-13. ()
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Intro: The degree of port wine stain (PWS) blanching following pulsed dye laser (PDL) therapy remains variable and unpredictable. Because of the limitations of current PDL therapy, alternative treatment approaches should be explored. The objective was to evaluate a novel methodology for selective vascular damage, combined photodynamic (PDT) and photothermal (PDL) treatment, using the in vivo chick chorioallantoic membrane (CAM) model.

Background: The degree of port wine stain (PWS) blanching following pulsed dye laser (PDL) therapy remains variable and unpredictable. Because of the limitations of current PDL therapy, alternative treatment approaches should be explored. The objective was to evaluate a novel methodology for selective vascular damage, combined photodynamic (PDT) and photothermal (PDL) treatment, using the in vivo chick chorioallantoic membrane (CAM) model.

Abstract: Abstract BACKGROUND AND OBJECTIVES: The degree of port wine stain (PWS) blanching following pulsed dye laser (PDL) therapy remains variable and unpredictable. Because of the limitations of current PDL therapy, alternative treatment approaches should be explored. The objective was to evaluate a novel methodology for selective vascular damage, combined photodynamic (PDT) and photothermal (PDL) treatment, using the in vivo chick chorioallantoic membrane (CAM) model. STUDY DESIGN/MATERIALS AND METHODS: Thirty microliters of benzoporphyrin derivative monoacid ring A (BPD) solution was administered intraperitoneally into chick embryos at day 12 of development. Study groups were: (1) control (no BPD, no light); (2) BPD alone; (3) continuous wave irradiation (CW) alone (576 nm, 60 mW/cm2, 125 seconds); (4) CW + PDL; (5) BPD+PDL; (6) PDT (BPD+CW); (7) PDL alone (585 nm, 4 J/cm(2)); and (8) PDT+PDL (BPD + CW followed immediately by PDL). Vessels were videotaped prior to, and at 1 hour post-intervention and then assessed for damage based on the following scale: 0, no damage; 1, coagulation; 1.5, vasoconstriction; 2.0, coagulation+vasoconstriction; 2.5, angiostasis; 3.0, hemorrhage. Damage scores were weighted by vessel "order." RESULTS: PDT + PDL resulted in significantly (P < 0.01) more severe vascular damage than was observed in any other study group: 127% more than PDT, 47% more than PDL alone. CONCLUSIONS: PDT + PDL is a novel and promising approach for selective vascular damage and may offer a more effective method for treatment of PWS and other vascular skin lesions. Copyright 2004 Wiley-Liss, Inc.

Methods: Thirty microliters of benzoporphyrin derivative monoacid ring A (BPD) solution was administered intraperitoneally into chick embryos at day 12 of development. Study groups were: (1) control (no BPD, no light); (2) BPD alone; (3) continuous wave irradiation (CW) alone (576 nm, 60 mW/cm2, 125 seconds); (4) CW + PDL; (5) BPD+PDL; (6) PDT (BPD+CW); (7) PDL alone (585 nm, 4 J/cm(2)); and (8) PDT+PDL (BPD + CW followed immediately by PDL). Vessels were videotaped prior to, and at 1 hour post-intervention and then assessed for damage based on the following scale: 0, no damage; 1, coagulation; 1.5, vasoconstriction; 2.0, coagulation+vasoconstriction; 2.5, angiostasis; 3.0, hemorrhage. Damage scores were weighted by vessel "order."

Results: PDT + PDL resulted in significantly (P < 0.01) more severe vascular damage than was observed in any other study group: 127% more than PDT, 47% more than PDL alone.

Conclusions: PDT + PDL is a novel and promising approach for selective vascular damage and may offer a more effective method for treatment of PWS and other vascular skin lesions.

Original Source: http://www.ncbi.nlm.nih.gov/pubmed/15216534

Evaluation of c-erbB-2 overexpression and Her-2/neu gene copy number heterogeneity in Barrett's adenocarcinoma.

Walch A1, Bink K, Gais P, Stangl S, Hutzler P, Aubele M, Mueller J, Höfler H, Werner M. - Anal Cell Pathol. 2000;20(1):25-32. ()
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Intro: Amplification of the Her-2/neu gene is accompanied by overexpression of its cell surface receptor product, c-erbB-2 protein. To investigate the degree of intratumoural heterogeneity we applied immunohistochemistry in primary Barrett's adenocarcinoma (BCA) (n = 6) and dysplasia adjacent to the carcinoma (n = 4). In addition, fluorescence in situ hybridisation (FISH) was performed in primary BCA (n = 5) and dysplastic areas (n = 4). For an objective evaluation digital image analysis and laser scanning microscopy were used. Five of six BCA showed a marked intratumoral heterogeneous staining pattern ranging from areas in which the tumour cells were negative or faintly positive to tumour areas with a strong staining of the entire membrane. Among the two dysplastic areas also a heterogeneous staining pattern was observed. FISH analysis revealed marked heterogeneity of intratumoral gene copy number changes in all BCA showing populations with different fractions of cells with polysomy, low level amplification and high level amplification. One dysplasia showed a minor population with Her-2/neu signal clusters. In conclusion, we observed marked intratumoural heterogeneity of c-erbB-2 protein overexpression and Her-2/neu gene copy number in the majority of the primary BCA analyzed. Digital image analysis and laser scanning microscopy were helpful in quantifying the variations in protein expression and DNA copy number in individual tumour cells. The observed heterogeneity could hamper the exact diagnostic determination of the c-erbB-2 status in small biopsies and possibly influence the effectiveness of a potential c-erbB-2 targeting therapy. Figures on http://www.esacp.org/acp/2000/20-1/walch.htm+ ++.

Background: Amplification of the Her-2/neu gene is accompanied by overexpression of its cell surface receptor product, c-erbB-2 protein. To investigate the degree of intratumoural heterogeneity we applied immunohistochemistry in primary Barrett's adenocarcinoma (BCA) (n = 6) and dysplasia adjacent to the carcinoma (n = 4). In addition, fluorescence in situ hybridisation (FISH) was performed in primary BCA (n = 5) and dysplastic areas (n = 4). For an objective evaluation digital image analysis and laser scanning microscopy were used. Five of six BCA showed a marked intratumoral heterogeneous staining pattern ranging from areas in which the tumour cells were negative or faintly positive to tumour areas with a strong staining of the entire membrane. Among the two dysplastic areas also a heterogeneous staining pattern was observed. FISH analysis revealed marked heterogeneity of intratumoral gene copy number changes in all BCA showing populations with different fractions of cells with polysomy, low level amplification and high level amplification. One dysplasia showed a minor population with Her-2/neu signal clusters. In conclusion, we observed marked intratumoural heterogeneity of c-erbB-2 protein overexpression and Her-2/neu gene copy number in the majority of the primary BCA analyzed. Digital image analysis and laser scanning microscopy were helpful in quantifying the variations in protein expression and DNA copy number in individual tumour cells. The observed heterogeneity could hamper the exact diagnostic determination of the c-erbB-2 status in small biopsies and possibly influence the effectiveness of a potential c-erbB-2 targeting therapy. Figures on http://www.esacp.org/acp/2000/20-1/walch.htm+ ++.

Abstract: Abstract Amplification of the Her-2/neu gene is accompanied by overexpression of its cell surface receptor product, c-erbB-2 protein. To investigate the degree of intratumoural heterogeneity we applied immunohistochemistry in primary Barrett's adenocarcinoma (BCA) (n = 6) and dysplasia adjacent to the carcinoma (n = 4). In addition, fluorescence in situ hybridisation (FISH) was performed in primary BCA (n = 5) and dysplastic areas (n = 4). For an objective evaluation digital image analysis and laser scanning microscopy were used. Five of six BCA showed a marked intratumoral heterogeneous staining pattern ranging from areas in which the tumour cells were negative or faintly positive to tumour areas with a strong staining of the entire membrane. Among the two dysplastic areas also a heterogeneous staining pattern was observed. FISH analysis revealed marked heterogeneity of intratumoral gene copy number changes in all BCA showing populations with different fractions of cells with polysomy, low level amplification and high level amplification. One dysplasia showed a minor population with Her-2/neu signal clusters. In conclusion, we observed marked intratumoural heterogeneity of c-erbB-2 protein overexpression and Her-2/neu gene copy number in the majority of the primary BCA analyzed. Digital image analysis and laser scanning microscopy were helpful in quantifying the variations in protein expression and DNA copy number in individual tumour cells. The observed heterogeneity could hamper the exact diagnostic determination of the c-erbB-2 status in small biopsies and possibly influence the effectiveness of a potential c-erbB-2 targeting therapy. Figures on http://www.esacp.org/acp/2000/20-1/walch.htm+ ++.

Original Source: http://www.ncbi.nlm.nih.gov/pubmed/11007435

Super Pulsed Laser, LED, LLLT (Cold Laser), Super Luminous Diode (SLD/LED/light cluster), IR McVay

- 2012 (Video)
This video gives a basic description of LLLT and shows a simple procedure
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This video gives a short description of how LLLT works, and shows the most basic procedure for using a laser for therapy. It also explains some of the differences between differnt types of lasers, and talks about penetratin depth.

video length: (2:22) 


Original Source: https://www.youtube.com/watch?v=uqBSBs-Vvqc

LLLT Kahn News clips

- (Video)
This is a 14 minute long video compilation of news reports about LLLT
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This is a compilation of news reports from the early 2000's about LLLT being used in a Canadian clinic primarily for atheletes.

video length: (13:47) 


Original Source: https://www.youtube.com/watch?v=-cFNMak6hOA

LLLT - CB Therapy Solutions Toronto

- 2016 (Video)
Therapist discuses the basics of LLLT while giving a basic demonstration of LLLT
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Therapist discuses the basics of LLLT while giving a basic demonstration of LLLT.

video length: (1:56) 


Original Source: https://www.youtube.com/watch?v=goYk_I4gxaI

THOR LLLT treatment of sports injuries

- 2008 (Video)
LLLT used on sports injury, video was posted by thor, could be biased
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LLLT used on sports injury.

video length: (0:41) 


Original Source: https://www.youtube.com/watch?v=z7OSDnANwqA

Dentist, Mark Dincher talks about his use of LLLT (sorry for the noisy environment)

- (Video)
Dentist describes his experience using LLLT on patients, video posted by thor, may be biased
View Resource

Dentist describes his experience using LLLT on patients.

video length: (3:57) 


Original Source: https://www.youtube.com/watch?v=pqhzwEWLMTA

Rio's Recovery with Laser Therapy - 2 Years Later

- (Video)
Video of a horse who is near euthanasia receives LLLT and is able to maintain the use of it's legs
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2 IA steroid injections + Hyaluronic Acid, systemic NSAID's, and chiropractic were administered, and joint support supplement was added to Rio's feed - with no improvement noted. Laser therapy was tried as a last resort prior to euthanasia. 15,000 total Joules were applied to Rio's left elbow and left shoulder. Over a year and a half later Rio is going strong

video length: (2:55) 


Original Source: https://www.youtube.com/watch?v=_3Sneef0fe0&nohtml5=False

TerraQuant Laser Therapy Equipment & Cold Laser Healing

- (Video)
made about terraquant, possible bias
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Informational video on LLLT, that turns into an ad at around (2:45) for terraquant.

video length: (7:06) 


Original Source: https://www.youtube.com/watch?v=mvSOxHJNFXw&nohtml5=False

Chiropractic Care Services & Treatments : Flexor Withdrawal Reflex Cold Laser Therapy Demonstration

- 2008 (Video)
Dr. Minors demonstrates increased flexibility after LLLT
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 See a flexor withdrawal reflex cold laser therapy demonstration for chiropractic care in this free health care video.

 video length: (4:28)


Original Source: https://www.youtube.com/watch?v=nHjlyLHd03w&nohtml5=False

Low Level Laser Therapy (LLLT) - Australian Laser & Skin Clinics

- 2013 (Video)
This is an introductory video to LLLT, it was made bu a chiropractic clinic, so it may be biased
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LLLT works by using light to stimulate, regulate and accelerate cell function in the area being treated in order to heal, restore and improve damaged tissue.

LLLT can be treated on any part of the body and restores injured tissue to return to a normal level in both structure and function, which alleviates symptoms that include swelling, redness, damaged skin, and pain.

video length: (1:47) 


Original Source: https://www.youtube.com/watch?v=x6I0DGHTKaQ&nohtml5=False

See the benefits of Cold laser Therapy

- 2008 (Video)
This video gives a simple description of LLLT, however the laser is used through clothing for demo purposes this would not be the case in actual LLLT
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This video gives a simple description of LLLT, however the laser is used through clothing for demo purposes this would not be the case in actual LLLT.

video length: (2:22) 


Original Source: https://www.youtube.com/watch?v=MD9-M-cN0_I&nohtml5=False

Cold Laser Therapy Hip Replacement Arthritis Pain Dr Paul Teich

- 2015 (Video)
A woman tells of her experience with LLLT
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video length: (0:54) 


Original Source: https://www.youtube.com/watch?v=NgpMTyXdlcc

Wounded tiger gets THOR LLLT / Low Level Laser Therapy treatment

- 2012 (Video)
2 videos of a tiger receiving LLLT, one video shows them giving LLLT to the tiger's eye, do NOT point any lights or lasers into your eye, it was also made by thor, so it could be biased
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Two videos of a tiger recieving LLLT on a wound and on it's eye, tiger does't seem to be in pain, but the videos simply don't show enough to make any real claims.

video length: (0:40) 

 

Tiger's eye gets THOR LLLT / Low Level Laser Therapy treatment

video length: (0:39)


Original Source: https://www.youtube.com/watch?v=FB5AykoLngo

Grizzly bear gets THOR LLLT / Low Level Laser Therapy treatment for Osteoarthritis

- 2012 (Video)
Grizzly Bear recieving LLLT for it's osteoarthritis of the hip, video made by thor, so it could be biased.
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Grizzly Bear recieving LLLT for it's osteoarthritis of the hip.

video length: (0:54) 



Alternative Carpal Tunnel Treatment. National News report on Microlight ML830® Cold Laser Therapy

- 2011 (Video)
This is a news report on a patient with Carpal Tunnel Syndrome who receives LLLT treatment, the video was posted by microlight, it may be biased
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Action News reports on the use of LLLT for relief from Carpal Tunnel Syndrome. LLLT provides relief from pain and inflammation, migraines, arthritis, fibromyalgia, back pain, neck pain, muscle injuries, ligament injuries, and many more.

video length: (3:02) 


Original Source: https://www.youtube.com/watch?v=bRe5U4sO4t4&nohtml5=False

THOR LLLT Cold Laser Therapy for Horses Equine THOR Photomedicine Ltd

- 20008 (Video)
Video demonstration of LLLT on a horse, video made by thor, so it may be biased
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Anna Johnson is the British 3 Day Olympic team equine physio. Here she demonstrates the THOR laser system for pain relief and tissue healing.

video length: (4:51) 


Original Source: https://www.youtube.com/watch?v=hC5CTON4G4Q&nohtml5=False

Cold Laser Therapy & Smoking Cessation

- 2015 (Video)
3 physical therapists discuss LLLT's efficacy in trying to quit smoking, They speak specifically about theralase, so it could be biased
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 In this video three physical therapists talk about using LLLT for pain management and for smoking cessation.

video length: (3:24) 


Original Source: https://www.youtube.com/watch?v=mdGNAI5mMCA&nohtml5=False

THOR LLLT in California

- 2010 (Video)
There is a small amount of info on LLLT in this video, but it's essentially an ad for thor/physical therapy
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This is essentially an ad for thor, and the physical therapy clinic mentioned, but it still contains a small amount of information on LLLT

video length: (2:00) 


Original Source: https://www.youtube.com/watch?v=of1DKWTpcaA

Low Level Laser Therapy For Treating Back Pain

- 2015 (Video)
This is an Australian news report on LLLT.
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LLLT also known as cold laser was featured on Channel 7 News with Dr Roberta Chow using low level laser to treat back pain

video length: (2:06) 


Original Source: https://www.youtube.com/watch?v=GPk5HxzF_kY&nohtml5=False

North Dallas and Plano Chiropractor Discusses Cold Laser Therapy

- 2011 (Video)
possible bias
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This video shows North Dallas and Plano chiropractor, Dr. Khayal, demonstrating the use of cold laser therapy, sometimes known as "cold light laser". Premier Health Chiropractic employs cold laser therapy as a part of its patients healing and recovery process, along with other chiropractic technologies such as the ProAdjuster and spinal decompression.

video length: (2:02) 


Original Source: https://www.youtube.com/watch?v=gpdY13Xazgc&nohtml5=False

cold laser therapy Miami

- 2016 (Video)
This is an animated ad for a Florida Chiropractic Clinic, but it does have a small amount of info on LLLT.
View Resource

 

video length: (1:04) 


Original Source: https://www.youtube.com/watch?v=IYrp6t4Y5xg&nohtml5=False

LLLT : Anybeam(Dental laser): Three in One dental laser, One Er:Yag(2940nm), Two Nd:Yags(1064nm, 1320nm)

- 2008 (Video)
specific laser used, possible bias (graphic content)
View Resource

Video of a LLLT procedure on a dental pateint.

video length: (1:56) 


Original Source: https://www.youtube.com/watch?v=RrJCCnsqN1w

Pain Relief with Microlight ML 830® Cold Laser Therapy - News Reports - Natural Pain Relief

- 2011 (Video)
made by microlight, possible bias
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Fox News 10 reports on the Microlight ML830® Cold Laser used for all types of pain relief.

video length: (4:58) 



Dr. Sam Lam Talks About the Capillus Low Level Laser Therapy (LLLT) for Hair Loss

- 2014 (Video)
made by capillus, Ad
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Dr. Sam Lam talks about a laser therapy device for hairloss, it is basically an ad, so be mindful of that.

video length: (3:25) 


Original Source: https://www.youtube.com/watch?v=7u6wwHCBlbQ

Cold Laser Therapy LLLT Quantum Healing Lasers

- 2010 (Video)
main speaker sells lasers, may be biased
View Resource

this video talks about the benificial effects of LLLT on all cells that are injured or ailing:

  • Brain cells
  • Skin cells
  • Bone cells
  • Nerve cells

It also states that LLLT has no effect on cells that don't need energy.

video length: (7:26) 


Original Source: https://www.youtube.com/watch?v=KUJinXH5tr4

How Cold Laser Therapy Works

- 2008 (Video)
This is a short video description of LLLT, along with some history of LLLT. The video is produced by the founder of scalar wave lasers, which makes many magical claims.
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Lasers as a medicinal tool have been researched ever since their discovery forty years ago. LASER is the acronym for Light Amplification by Stimulated Emission of Radiation. Albert Einstein was the first person to discover the presence of laser; however it was Theodre Maiman who invented the first working ruby laser. He managed to produce a red colored laser from ruby crystal which was so intense that it could bore through several layers of stacked razor metals. The laser produced was powerful but short-lived. Since then much research has taken place in this area.
Low level lasers are characterized by low intensity levels and were used by Endre Mester, a Hungarian scientist in his medical research and he presented the paper on utility of Low level lasers in medicine in 1969. This resulted in astounding discoveries -- laser beams relieved patients from pain, hastened recuperation, and drastically cut down marks and blemishes.
LLLT- The Science behind It
The photons, carriers of electromagnetic radiations, an inherent component of all wavelengths of light activate the multifunctional nucleotide, ATP. ATP (Adenosine Triphosphate) contain high energy phosphate bonds which transport energy to cells for biochemical processes including muscular contraction and enzymatic metabolism, thereby restoring the normal enzymatic balance and energy levels. This, in a radical but natural manner, accelerates the healing process.
LLLT is characterized by typical LASER attributes of coherence, polarization and monochromaticity. They are narrow and shiny beams which can penetrate and be easily assimilated by the body. Low level LASERs have a specific wavelength range. The frequency of light is given by the movement of light moving upward and downward. 
How It Works
Low level laser therapy works in a similar manner to the photosynthesis in plants where the sun's energy is used by the plants which initiate crucial cellular processes hastening the cell production and rejuvenating processes of the plant cells. 
In the similar way, the photons of LLT reach the human body. While the body can be compared to the plant, the low level laser light is similar to the sun light. Once absorbed, the LASER activates the cell metabolism and cell reconstruction. The Low Level Laser Therapy rays are capable of boring 3 inches deep into the body. These rays insert bio photons into the damaged and the living cells. These cells start producing ATP improving their function, strengthening the body resistance by producing collagen, enzymes thereby improving the synthesis of various hormones. These substances are basic for the healthy functioning of the body cells. Hence the tissues are healed and pain disappears.
With photons as the driving force, the Low Level Laser is the silent healer of wounds, pains and dermatological disorders. It is established beyond doubt that unlike other drug or therapy, Low Level Laser Therapy has no peripheral or undesirable secondary effect. A laser is critical in revitalizing the impaired or injured cells by improving the resistance or immunity. Low Level Laser Therapy will go a long way in medical history and it has come to a stay.

video length: (4:00) 


Original Source: https://www.youtube.com/watch?v=v9fHMR94t_I

M6 Cold Laser Therapy for Knee Pain

- 2015 (Video)
Advertisement
View Resource

Advertisement that at least shows LLLT being used on patients.

video length: (2:09) 



(LLLT) Low Level Laser Therapy - The Drs TV SHOW

The Doctors - (Video)
TV show excerpt with obvious ad at the end
View Resource

This video is not exactly the autority on LLLT, it does show some results in the use of LLLT in hairloss at (6:24); however it has a shameless hairloss clinic plug at the end, so take it with a grain of salt. 

 video length: (7:55)


Original Source: https://www.youtube.com/watch?v=bm4KhRTsUlY

Home Search Introduction

Ken Teegardin - (Video)
View Resource

Welcome to the laser-therapy.us research tool. This tool is a searchable collection of technical publications, books, videos and other resources about the use of lasers for photobiomodulation. This tool includes almost the entire U.S. library of medicine research papers on LLLT, videos from Youtube associated with therapy lasers and the tables of contents from laser therapy books. This allows users to search for a keyword or condition and see resources about using lasers to treat that condition. All the resources include links to the original source so we are not making any statement about the use of lasers for treating non-FDA cleared application, we are simple summarizing what others have said.  Where every possible, we have included a link to the orginal publication.

Here are some of our favorite queries:

This tool uses a broad match query so:

  • It does not correct spelling and searches only cold laser related subjects so do not use LLLT, cold or laser in the search bar
  • It works better with shorter search terms or even parts of search terms
  • It searches all the available fields so you can enter a body part, author, condition or laser brand.
  • Where ever possible, the detailed section about the resource will link to the sources.
  • This system is only for photobiomodulation or cold laser therapy research (including LLLT, laser acupuncture and high power laser therapy) only. It does NOT include photodynamic laser therapy (where the laser is used to react with a pharmaceutical), hot surgery lasers or cosmetic lasers. It does include some resources on weight loss and smoking cessation.

The results of the search are sorted based on 3 quality factors on a scale of 1 to 10 with 10 being the best score. Originally all the resources were given a 5-5-5 until they could be individually evaluated. These scores are purely opinion and are only used to simplify the rank of the results from more valuable to least valuable. This should not be considered a critique of any work. This system was created to help researchers (including ourselves) find the most usable resources for any cold laser therapy research. The resources are assigned values based on the following 3 factors:

  • Efficacy: The resource (especially research papers) should show a significant improvement in the condition being treated. Resources that show better results are given a higher quality score.
  • Detail: The source must give enough information that the results can be duplicated. If a resource lacks too many details that it cannot be recreated, it is given a lower detail score.
  • Lack of Bias: Many resources are created to try and show that one device is superior to its competition. Many manufacturers have staff that crank out biased papers on a regular basis on the hope that this will make their product look superior. If the author of the resource is paid by a manufacturer of the resource appears to be biased towards one device and not one technology, the resource has much less value.

Over the past few years of working with research, we found that a majority of the published resources are lacking in one of these three ranking factors.
The original goal of this research tool was to tie published resources to the protocols in the laser-therapy.us library. This connection allows users to trace each protocol back to a list of resources so the protocol can be researched and improved.

General Comments


POWER
When many of the first research papers were published, the most power laser available for therapy were less than 100mW and many systems had to be pulsed to keep the laser from burning out too quickly. Today, system are available that will deliver up to 60,000mW of continuous output. Because of these power limitation, many early studies were limited to extremely low dosages by today’s standards. It takes a 50mW system 17 minutes to deliver 50 joules at the surface of the skin. If this was spread over a large area of damage or was treating a deeper problem, the actual dosages were much less than 1J/cm2.  Today, we know that these dosages typically produce very little or no results.
WAVELENGTH
About 80% of the resources in this database are in the near infrared wavelength. There is also some interest in the red wavelength (600 to 660nm) . Other wavelengths like blue, purple, and green have very little scientific research behind them and have not gotten much traction in the core therapy market with the exception of some fringe consumer products.
Legal Disclaimer
This research tool is free to use but we make no claims about the accuracy of the information. It is an aggregation of existing published resources and it is up to the user to determine if the source of the resources has any value. The information provided through this web site should not be used for diagnosing or treating a health problem or disease. If you have or suspect you may have a health problem, you should consult your local health care provider.



The query result(s) can be shared using the following direct link. Anyone who clicks on this link in an email or on a web site will be shown the current results for the query.
https://www.laser-therapy.us/research/index.cfm?researchinput=video