LOW LEVEL LASER ASSISTED LIPOPLASTY, L.A.L. A NEW TECHNIQUE. NEIRA
4L TECHNIQUE
Rodrigo Neira, C.Ortiz, J.Arroyabe et al.
This study describes the scientific basis for a new lipoplasty technique
based on the use of a low-level energy laser diode beam. A
multidisciplinary team studied fat samples randomly taken from ten
patients that underwent a liposculpture procedure.
Fat samples were processed as follows:
Application of tumescent technique and exposure to laser beam for 4
minutes. Partial disruption of the adipose cell was observed; several
cells without disruption of the cellular membrane were preserved. The
adipose cells lost their round shape, and fat spread into the
intercellular space.
Application of tumescent technique and exposure to laser beam for 6
minutes. Transitory pores were observed in the cell membrane. There was
found microscopic evidence that fat was outside the adipose cells, and
remained in the interstitial space. Structures such as the capillaries and
the remaining interstitial space, were however preserved.
Without the use of tumescent solution, in vitro exposure of adipose tissue
to laser beam for 4, and 6 minutes was performed and compared with samples
without laser exposure (Zero minutes). Laser penetration through adipose
tissue decreased when the tumescent solution was not utilized. The
Scanning and Transmission Electron Microscopic findings after six minutes
laser exposure without the use of tumescent solution correspond to those
observed at 4 min. laser exposure by equal intensity (10 mW) combined with
the use of a tumescent solution, suggesting that the application of the
tumescent solution is a important enhancement factor. Adypocite cultures
confirmed what is happening with the adipose cell after irradiating it
with the laser beam. These cells remain alive in spite of the membrane
deformation generated by the exposure to the laser beam for 6 minutes
LOW – LEVEL- LASER THERAPY IN MILD AND MODERATE CTS – A DOUBLE
BLIND, RANDOMISED STUDY
Th. Rappl, Ch. Laback, St Quasthoff, M. Auer-Grumbach, R. Gumpert, E.
Scharnagl
The aim was to evaluate the LLLT in CTS (ENG: < 6,9 ms) monitored by EMG
and VAS (Visual Analogous Scale) recordings. 72 hands with CTS treated by
LLLT (15 sessions/30 min, over a period of 5 weeks) were evaluated by a
double blind – randomised study. ENG and VAS (visual analogous scale) were
performed pror to and after LLLT.
LLLT (wavelength 830 nm, 400 mW) with an energy of 3J per point focused on
the Carpal – tunnel, on trigger and acupuncture – points was performed in
38 cases, in 38 cases (control – group) we used a red light pen. Follow-up
ranged from 8 to 12 months. ENG and VAS improved in 66%, didn’t change in
8% and got worse in 26% in the LLLT group after a 12 month period. No
improvement was recorded in the control group. The results suggest that
LLLT can be recommended in mild or average CTS (ENG < 4,9 ms) especially
if a conservative treatment is required.
THE EFFECT OF LOW POWER LASER THERAPY ON OSTEOARTHRITIS OF THE
KNEE
Basirnia A., Sadeghipoor G., Esmaeeli Djavid G. et al.
Treatment was performed on 20 patients, aging from 42 to 60 years. All
patients had received conservative treatment with poor results. Laser
device used for this treatment was pulsed IR diode laser; 810 nm
wavelength once per day for 5 consecutive days, followed by a 2-day
interval .The total number of applications was 12 sessions. Irradiation
was performed on 5 periarticular tender points, each for 2 min. The
treatment outcome (pain relief and functional ability) was observed and
measured according to the following methods: 1) Numerical rating scales (NRS),
2) Self assessment by the patient, 3) Index of severity for osteoarthritis
of the knee (ISK), 4) Analgesic requirements. We achieved significant
improvement in pain relief and quality of life in 70% of patients,
comparing to their previous status (p<0.05). There was no significant
change in range of motion of the Knee.
THE USE OF LOW LEVEL LASER THERAPY (LLLT) IN THE TREATMENT OF TRIGGER
POINTS THAT ARE ASSOCIATED WITH ROTATOR CUFF TENDONITIS.
Al-Shenqiti, J Oldham
60 patients were randomly allocated to either sham or laser therapy. The
active laser parameters included a wavelength 820 nm, power output 100 mW,
frequency 5000 Hz (modulated) and energy density 32 J/cm2. 12 treatments
were given over four weeks. The blinded outcome measures were pain, range
of motion (ROM), functional activities and pressure pain threshold (PPT).
Outcome measures were carried out pre and post treatment, then 3 months
later. Considerable improvement in pain (p < 0.001) was seen for the laser
compared to sham group post treatment, and at follow-up (6 points on a 10
VAS compared to 2 points respectively). Similarly, significant differences
in favour of laser were seen for ROM (p < 0.01), functional activities (p
< 0.001) and PPT (p < 0.05).
THE INFLUENCE OF LOW LEVEL INFRA RED LASER THERAPY ON THE REGENERATION OF
CARTILAGE TISSUE
P.Lievens , Ph.van der Veen
This study concerns the influence of Laser treatment on the regeneration
process of cartilage tissue. There is no need saying that the regeneration
of cartilage tissue is a very big problem in rheumatic diseases for
example. The lack of blood supply is one of the most important factors
involved. Lots of previous publications give us proof of the regeneration
capacities of Laser therapy (in wound healing, bone repair etc.)
In this study we have chosen to experiment on cartilage tissue of the ear
of mice. We are aware of the fact that the elastic cartilage tissue of the
ear is not totally comparable with the hyaline cartilage of articulations.
For technical reasons however and because of the fact that the
chondrocytes are comparable, we decided to use mice ears in our
experiment. A 0,4 mm hole was drilled in both ears on 30 mice. The right
ears remain untreated, while the left ears were treated daily with IR-Laser
(904 nm) for 3 minutes. Macroscopical as well as histological evaluations
were performed on the cartilage regeneration of both ears.
Our results show that after one day postsurgery no differences were found
between the irradiated and the non-irradiated group. After the second day,
only in the irradiated group there is a clear activation of the
perichondrium. After four days, there is a significant ingrowth of the
perichondrium into the drill hole in the experimental group and there is
only an active perichondrium zone in our control group.
THE INFLUENCE OF IR-LASER ON THE PROLIFERATION OF FIBROBLASTS: AN
IN-VITRO STUDY
Ph.van der Veen, Y de Rop, P. Lievens
To control the reproductability, the inter-and intra reliability, we
cultivated cells coming from the abdomen of two different (NMRI) mice and
we divided 4 groups per mouse. Two were irradiated, two were not. Then we
did a BrdU-labeling with 4 flasks (2 were irradiated, 2 were control).
Differences between the experimental and control groups were examined by
means of a t-test and a non-parametric Mann-Whitney test. The results show
a significant (p<0,05) increase of fibroblasts proliferation after IR-irradiation.
The BrdU-labeling showed an increased DNA activity. There is also a
perfect match between the increased number of fibroblasts and the DNA
activity.
PHOTOBIOMODULATION OF HUMAN T-LYMPHOCYTE PROLIFERATION IN VITRO
M Dyson, A Agaiby, L Ghali
The biomodulatory action of low level laser therapy (LLLT) on human
T-lymphocyte proliferation was investigated in vitro at energy densities
ranging from 1.2 to 13.2 J/cm2. The wavelength, pulsing frequency and
power output were maintained constant at 820 nm, 5000Hz and 50 mW
respectively. The T-lymphocytes used in these experiments were separated
from human peripheral blood; monocytes obtained from the same blood
samples were added to suspensions of the T-lymphocytes to induce
proliferation. Cell suspensions of 106 cells/ml were divided into 2
aliquots, one of which was treated with the mitogen phytohaemagglutin (PHA).
The mitogen treated and non-mitogen treated cells were either exposed to
coherent infrared radiation or were sham-irradiated. The cells were then
cultured for 3 days after which their ability to incorporate 3H-thymidine
was used as a measure of proliferation. Exposure of non-mitogen treated
T-lymphocytes to energy densities of either 1.2 or 3.6 J/cm2 stimulated
their proliferation, whereas energy densities of 10.8 and 13.2 J/cm2 were
inhibitory. In contrast, the proliferation of the mitogen treated
T-lymphocytes was inhibited by all the energy densities tested in the 1.2
to 13.2 J/cm2 range. The results indicate that the sensitivity of these
cells to LLLT varies according to their proliferative level, only non-mitogen
treated cells being capable of increased proliferation. Although cell
proliferation can be increased in non-mitogen treated (i.e. resting)
T-lymphocytes by exposure to low energy densities, there appears to be an
energy density limit above which inhibition of cell proliferation occurs.
Cells whose mitotic activity had been stimulated by PHA had their
proliferation inhibited by energy densities, which stimulated
proliferation in resting cells. If the photobiomodulation of T-lymphocyte
proliferation observed in vitro also occurs in vivo, then LLLT could be of
clinical value in the treatment of various lymphoproliferative disorders.
AN IN VITRO STUDY OF THE EFFECTS OF LOW-LEVEL LASER RADIATION ON
HUMAN BLOOD
Dan G. Siposan
In the last time the study of the effects of Low-Level Laser Radiation (LLLR)
on the blood is considered to be a subject of great importance in
elucidating the mechanisms of action between LLLR and biologic tissues.
Different methods of blood phototherapy have been developed and used in
clinical purposes with benefic effects. This study investigates some in
Vitro effects of LLLR on some selected rheologic indices of human blood.
After establishing whether or not damaging effects could appear due to
laser irradiation of the blood, we tried to find a new method for
rejuvenating the blood preserved in haemonetics-type bags. Blood samples
were obtained from adult regular donors (volunteers). HeNe laser and laser
diodes were used as radiation source, in a wide range of wavelengths,
power densities, doses and other parameters of irradiation protocol. In
the first series of experiments we established that LLLR does not alter
the fresh blood from healthy donors, for doses between 0 and 10 J/cm3 and
power densities between 30 and 180 mW/cm3. In the second series of
experiments we established that LLLR does have, in some specific
conditions, a revitalizing effect on the erythrocytes in preserved blood.
We concluded that laser irradiation of the preserved blood, following a
selected protocol of irradiation, could be used as a new method to improve
the performances of preservation: prolonging the period of storage and
blood rejuvenation before transfusion.
SEM AND AFM STUDIES OF RAT INJURED TIBIAE AFTER HeNe RADIATION.
Cruz-Höfling A, Garavello Freitas Z, Baranauskas I B.
Atomic Force Microscopy (AFM) and Scanning Electron Microscopy (SEM) were
used to quantify bone morphology during post-injury ossification in rat
tibiae and characterise the differences induced by laser compared with the
naturally occurring regenerative process. A 1.5 diameter hole was done
surgically in the tibia and two different doses of laser were applied
during 7 or 14 consecutive days, starting 24 hrs after lesion. The
collagen fibre lamellar organisation in the matrix, typical of mature
bone, was promoted by the HeNe laser at doses of either 31.5 J/cm2 or 94.5
J/cm2.
LLLT ON DAMAGED MUSCLE CAUSED BY BOTHROPS MOOJENI SNAKE VENOM.
Dourado DM, Cruz-Höfling MA.
The venom of the bothrops moojeni snake was injected into the
gastrocnemius of mice to mimic the effect of a snakebite. Traditional
therapies for this snakebite have proven less effective. Three groups were
tested: A=saline, B=venom and C=venom+ laser. Two sessions of HeNe laser
at 4 J/cm2 during 1 m 32 s were administered and the animals were
sacrificed at 24 h, 3 d and 7 d, respectively. The analysis showed
myonecrosis with inflammation and an extensive area of degenerated fibres.
In the laser group there was, by day 3, an incipient number of
regenerating fibres. Laser accelerated the phagocytisis of fibre remnants
and recovery of the tissue, decreasing the oedema and increasing
regeneration.
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