Online ISSN : 1884-7269
Print ISSN : 0898-5901
ISSN-L : 0898-5901
19 巻 , 3 号
Kaplan's Corner
Review Article
  • Kendric C. Smith
    2010 年 19 巻 3 号 p. 135-142
    発行日: 2010年
    公開日: 2010/09/30
    ジャーナル フリー
    There are many molecular targets for Low Level Light Therapy (LLLT). The chief target appears to be cytochrome C oxidase in mitochondria, which then initiates a cascade of molecular events that signal the cell to perform various functions. Although visible light can produce photochemistry, infrared radiation only produces molecular rotations and vibrations. A probable explanation of how 633 nm radiation can produce the same biological effect as 904 nm radiation will be presented. The light activation of enzymes by multiple mechanisms will be discussed. To further enhance the scientific basis of LLLT, I propose that gene array experiments be performed at the wavelengths that have been shown to be most effective for different therapies with LLLT. Then we will know what genes are activated by the different wavelengths, and therapy can then be designed with greater confidence for success. It will also help us to determine if the use of more than one wavelength in a therapy might be advantageous. Think of the different wavelengths of light as different drugs, therefore it is important to determine which drug is best, and also the optimum dose.
Original Articles
  • Masayoshi Okada, Masato Yoshida
    2010 年 19 巻 3 号 p. 143-147
    発行日: 2010年
    公開日: 2010/09/30
    ジャーナル フリー
    Background: The minimally invasive endovascular management of various peripheral arterial diseases has attracted attention worldwide. Based on the results studies, we examined the use of the argon laser in endovascular intervention for peripheral arterial diseases.
    Materials and Methods: We first performed some preliminary animal experiments applying the argon laser endovascularly both with the bare fiber and with a laser-heated tip with a range of parameters. Based on the results of these studies the optimum parameters were set at 6 W output power with a 3 sec exposure for the laser fiber, and for the heated tip angioplasty approach, a tip temperature of 200°C with a 5 sec exposure. Using these parameters we have treated a total of 115 patients, 113 with intermittent claudication and 2 with crural ulcers.
    Results: Endovascular argon laser intervention using our elicited parameters was clinically and successfully performed for all patients in the study population, with clear improvement in their clinical symptoms. The follow-up period has ranged from 6.5 to 10 years, (average 8.3 years), with no signs of recurrence. No adverse side effects have been reported.
    Conclusions: Our results have clearly demonstrated that endovascular laser intervention with an argon laser was a useful method for a variety of peripheral arterial diseases, with excellent results seen in an average 8.3-year follow-up. Endovascular laser intervention can therefore be recommended for those patients with peripheral arterial diseases.
    Akinobu Shoji
    2010 年 19 巻 3 号 p. 149-158
    発行日: 2010年
    公開日: 2010/09/30
    ジャーナル フリー
    Aims and background: We investigated what could hinder the effect of treatment with near-infrared laser therapy (830nm) around the stellate ganglion (SGL) in the treatment of atopic dermatitis (AD), the relationship between the skin symptoms score (SS) and the tenderness score (TS) and potential influence of oral steroid therapy on SS and/or TS.
    Subjects and methods: Study subjects comprised patients with serious and moderate AD treated with or without oral steroids: males 164, females 194, total 358. All patients were treated with ordinary medications together with an SGL treatment to improve the patients’ lifestyle. The SS was evaluated by the patients themselves using a scale of 0 to 10. A digital pressure of approximately 5kg was applied to the tender point sites to calculate the tenderness score (TS), which was calculated as follows: TS=LE+Ax+MSC+SM. For the χ2 test, data of SS and TS were first divided into 10 categories by the number of SG-L treatments and then two groups by its effect.
    Results: In the steroid group, no categories out of ten categories classified by the number of the SGL days showed any significant difference in either the TS or SS, but in the non-steroid group, one category in the male, eight in the female, and nine in the total groups showed a simultaneous statistically significant difference in both the TS and SS.
    Conclusions: These results show that the patients with atopic dermatitis should not be treated with long term use of oral steroid except for unavoidable cases.
  • Yoshinari Matsumoto, Yoichi Akita, Hirono Nakaseko, Chiharu Kawamura, ...
    2010 年 19 巻 3 号 p. 159-166
    発行日: 2010年
    公開日: 2010/09/30
    ジャーナル フリー
    Background: Photodynamic therapy (PDT) is a novel noninvasive dermatological therapy that has been used together with topical application of 5-aminolevulinic acid (ALA) to treat non-melanoma skin cancers and non-oncological diseases. Multicenter randomized controlled studies have now demonstrated high efficacy of PDT in actinic keratoses and Bowen’s disease. However, it seemed possible that topical PDT would be less effective in brown-skinned individuals, including Japanese, than in white Caucasians.
    Aim: Establish a standard treatment modality of ALA-PDT in Japanese patients in order to evaluate and improve the effects of PDT in the treatment of actinic keratoses and Bowen’s disease.
    Materials: A total of 152 lesions of actinic keratoses and 48 lesions of Bowen’s disease in Japanese patients were treated with ALA-PDT using our protocol.
    Methods: Lesions were treated in three sessions, one week apart, with 50J/cm2 irradiation in each session for a total dose of 150J/cm2 in actinic keratoses, and 100J/cm2 irradiation in each session for a total dose of 300J/cm2 in Bowen’s disease.
    Results: We achieved overall complete response rates of 81.6% (124/152 lesions) in total actinic keratoses, especially 87.2% (109/125 lesions) for lesions on the face/scalp, and 75.0 % (36/48 lesions) in Bowen’s disease, especially 88.9% (8/9 lesions) for lesions on the trunk. We have also treated non-oncological diseases, such as recalcitrant warts, cutaneous sarcoidosis and other diseases with ALA-PDT with satisfactory outcomes.
    Conclusions: The ALA-PDT according to our protocol was very successful in the treatment of Japanese patients with actinic keratoses or Bowen’s disease. A therapeutical benefit of PDT is evident in inflammatory and other dermatoses.
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