We have used infrared irradiation therapy in conjunction with brace treatment for 15 patients affected by Perthes disease. In nine patients with nine hips treated by infrared irradiation since the sclerosis stage or earlier, X-rays showed that the mean duration of sclerosis stage was four months, that of fragmentation stage was 6.1 months, and the mean interval between acme and reconstitution of the epiphyseal nucleus contour was 4.2 months. The course of disease after fragmentation stage was shortened. With the combination treatment initiated in the sclerosis stage or earlier, the deformity of epiphyseal nucleus was slight even at acme by X-rays in all patients. Combination of brace treatment with infrared irradiation is expected to induce early formation of lateral pillar, reduce duration of the treatment of Perthes disease and prevent exacerbation of the head deformity, provided that irradiation is initiated in or before the sclerosis stage.

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It certainly falls within the aims and scope of any international or national laser society to help regulate the safe use of the laser or any other form of phototherapy, and the Japan Society for Laser Surgery and Medicine (JSLSM) is one of the longest-established laser societies in the world, with a large and active membership and annual meetings which are well-attended each year. The JSLSM maintains contacts within the Japanese Ministry of Health, Labour and Welfare, and has acted in an advisory capacity for many years. At the 2006 meeting of the JSLSM, new safety guidelines in various fields were adopted, including the very precise field of photodynamic therapy (PDT). The following is the set of JSLSM guidelines for the application of PDT for early stage lung cancer, which the author offers as a starting point for comments and discussion from interested international bodies.

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Low reactive-level laser therapy (LLLT) is now used routinely in many sports medicine facilities, but little study has been done on whether the concomitant application of LLLT with analgesics and anti-inflammatories results in no change in either modality when used alone, produces a synergistic effect or actually weakens the reaction. The present study examines first the scientific literature on the effect of LLLT on concomitantly ingested medication. The study comprises three parts: first, the literature study; second, how the literature has reported on possible LLLT-pain medication interactions; and third, the principal author's own study on laser pharmacology and Achilles tendinitis. The Achilles tendon, although the largest and strongest in the human body, has since classical times been recognized as a weak point. In the case of the legendary Achilles, he was dipped in the river Styx by his mother, rendering him invulnerable, except for the portion of his heel where he was held, thus giving rise to the 'Achilles' heel'. However, an arrow guided by Apollo pierced Achilles' heel, severed the tendon and killed him through the only point on his body which was vulnerable. In the case of real-life athletes, it is repetitive body load which does the damage to the tendon which bears Achilles name. The whip effect of pronation in the running gait and potential intrinsic weakness or collagen deterioration with age makes this tendon very vulnerable to damage. The poor results in the treatment of Achilles tendinopathy with conservative therapy and even low level laser therapy on its own pushed us to use a combination of LLLT and local infiltration of concomitant medication. The subjects were 100 successive athletes, with chronic Achilles tendinopathy. These patients had already undergone conservative treatment for six months without positive results. Our method was a combination of laser photodynamic therapy (PDT) with Plenosol® intradermally and 660 nm LLLT followed by a cooling down treatment with Ubiquinon, Ferrum and Cu⁺⁺ infiltrated subcutaneously, together with LLLT at 660 nm, 830 nm and 904 nm. With an average of 4 treatments within 14 days, we reached a healing time of 16 days to restart training, with an overall success rate of 90%. With these results, we concluded that a good knowledge of interaction between laser and pharmacology can reduce our treatment time, even for chronic diseases.

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