Now that laser technology has emerged from hospital operating rooms, and has become available to office practices, clinics, and private enterprises, the burden of responsibility for safety has shifted from hospital staff to the individual user, often without benefit of appropriate or adequate resources. What remains, regardless of the practice site, application, or system in use, is the constant goal of establishing and maintaining a laser safe environment for the patient, the staff, and the user, at all times. This should be the goal of all who are involved with the sale, purchase, application, and management of all medical laser systems - under all circumstances. Laser safety is EVERYONE’S concern! A laser is as safe or as hazardous as the user - and that user’s knowledge and skill, defines how well laser safety is managed. Of all hazards, complacency is the most dangerous, and it is imperative to develop a risk management perspective on laser safety. Proper safety management requires a fourfold approach including: knowledge of standards, identification of hazards and risks, implementation of appropriate control measures, and consistent program audit to demonstrate quality assurance.
Objectives: Photodynamic therapy (PDT) was performed on 14 cases of tracheobronchial malignancies with variable tumor stages as an adjunct to surgery. We retrospectively reviewed these PDT cases to evaluate safety and oncologic outcome. Methods: From June 2004 to August 2010, PDT was performed in 14 cases for lung cancer. Medical records were reviewed, including demographic data, indication of the PDT, and oncologic outcomes, during the follow-up period. Results: There were 5 deaths, 1 loss of follow-up, and 5 patients that are still alive. There were 8 cases of complete response (CR), 4 cases of no response (NR), and 2 cases of partial response (PR). Among the recurrent tracheoendobronchial lesions in 5 patients, CR was accomplished in 4 patients and NR was observed in 1 patient. The mean survival of all patients was 23.9 months after PDT with a range of 6 - 66 months. Conclusion: PDT demonstrates a safe and effective role as an adjunct to surgery in treating recurrent mucosal carcinoma in surgically high-risk patients. It is also effective for palliation of bronchial obstruction by cancer mass.
Background and Aims: Sacroiliac joint pain not associated with a major etiological factor is a common problem seen in the orthopedic clinical setting, but diagnosis is difficult because of the anatomical area and thus it is sometimes difficult to effect a complete cure. Low level laser therapy (LLLT) has been well-reported as having efficacy in difficult pain types, so the following preliminary study was designed to assess the efficacy of LLLT for sacroiliac pain. Materials and Methods: Nine patients participated, 4 males and 5 females, average age of 50.4 yrs, who attended the outpatient department with sacroiliac pain. The usual major disorders were ruled out. Pain was assessed subjectively pre-and post-LLLT on a visual analog scale, and trunk range of motion was examined with the flexion test to obtain the pre- and post-treatment finger to floor distance (FFD). The LLLT system used was an 830 nm CW diode laser, 1000 mW, 30 sec/point (20 J/cm2) applied on the bilateral tender points twice/week for 5 weeks. Baseline and final assessment values (after the final treatment session) were compared with the Wilcoxon signed rank test (nonparametric score). Results: All patients completed the study. Eight of the 9 patients showed significant pain improvement and 6 demonstrated significantly increased trunk mobility (P <0.05 for both). Conclusions: LLLT was effective for sacroiliac pain, and this may be due to improvement of the blood circulation of the strong ligaments which support the sacroiliac joint, activation of the descending inhibitory pathway, and the additional removal of irregularities of the sacroiliac joint articular surfaces. Further larger-scale studies are warranted.
Background: Studying the behavior of living organisms under the action of some physical or chemical factors (corpuscular or electromagnetic radiation, magnetic or electric field, sound waves, salinity, stimulants etc.) is enjoying major interest nowadays. 1,2) The main goal is to understand the mechanisms of action of these factors on biological tissues, and use this knowledge for applications in biology and medicine. A special place in modern medicine is occupied by the therapeutic applications of laser radiation. Aims: In the current study we are attempting to determine whether the therapeutic lasers used in medicine have the potential to produce changes of some morphological and physiological parameters of plants. If these changes actually occur, the next task is to determine whether they are due to laser action on water used for watering by changing its properties, or by the direct action of laser radiation on the plants cells. Matcrials and Mcthods: We used as samples two groups of wheat seeds, planted in cotton. In the first group we only irradiated irrigation water, while in the second group only plants. We used as sources of radiation lasers and LEDs, with wavelengths between 455 nm and 850 nm. Power density was P = 50 mW/cm2 for all samples, the exposure time ranged between 1s and 80s, and energy density (or fluence) between 0 and 4J/cm2. We measured modifications of some morphological and physiological parameters (the biomass quantity, germination rate of seeds, number and height of the seedlings etc.) as a function of fluence. Results: When only irrigation water was irradiated, we have found for all wavelength used a strong inhibitory effect on germination (between 30% and 50% for samples grown in the ground and between 13% and 40% for those grown in cotton). Regarding the other parameters determined, a stimulating effect, but less pronounced than if the plant was only irradiated, was noticed. When only plant was irradiated, the effects are altered depending on the wavelength and fluence. Discussion and conclusion: Although apparently different, plant and animal cells have some similar characteristics, the differences between them not being essential, involving mainly the quantitative aspect. In these circumstances the study of the monochromatic radiation effects on plants is useful to characterize the action of those radiations on the animal and human tissues. Studies on plants exhibit a series of advantages: they are cheap, easily reproduced and suitable for producing good statistics etc. It can also be verified as to which extent the laws of classic photobiology show modifications when low level lasers are utilized.
Background and Aims: Red laser light of wavelength 630 nm is usually used for Photofrin®-mediated photodynamic therapy (PDT). The 630-nm light employed in PDT corresponds to the region of the wavelength used in low-level laser therapy (LLLT) may influence on the photodynamic effect required for killing cancer cells. The aim of this in vitro study was to investigate the changes in cell viability and degree of cell proliferation after Photofrin®-mediated PDT using 630-nm pulsed laser irradiation (10 Hz repetition rate and 7-9 ns pulse width), which was clinically found to induce no remarkable cell injury. Materials and Methods: A study has been conducted in which HeLa cells are incubated with Photofrin® for 15 min (10 μg/ml). Irradiation was carried out at an average fluence rate of 50 mW/cm2 with light doses of 1, 3, and 5 J/cm2. The cytotoxic effects on the cells are evaluated by the XTT (2,3-bis[2-methoxy-4-nitro-5-sulfophenyl]-5-[(phenylamino)carbonyl]-2H-tetrazolium hydroxide) assay. Results: The results showed that the laser irradiated cells exhibited a greater clonogenic activity than normal and PDT treated cells for a short period after the laser irradiation. Conclusion: If the level of 630-nm pulsed laser irradiation employed in a PDT is comparatively lowered, it would have a biostimulatory effect like that of in LLLT.
The basic properties of lasers and pulsed light sources limit their ability to deliver high energy to the dermis and subcutaneous tissues without excessive damage to the epidermis. Radiofrequency was shown to penetrate deeper than optical light sources independent of skin color. The early RF-based devices used single source bipolar RF, which is safe but limited in use due to the superficial flow of energy between the two bipolar electrodes. Another type of single source RF employs a single electrode (monopolar) in which the RF energy flows from one electrode on the surface of the skin through the entire body to a plate under the body. Although more effective than bipolar, this devices require intense active cooling of the skin and may be associated with considerable pain and other systemic and local safety concerns. Latest generation of RF technology developed by EndyMed Medical Ltd. (Caesarea, Israel) utilizes simultaneously six or more phase controlled RF generators (3DEEP technology). The multiple electrical fields created by the multiple sources “repel” or “attract” each other, leading to the precise 3 dimensional delivery of RF energy to the dermal and sub-dermal targets minimizing the energy flow through the epidermis without the need for active cooling. Confocal microscopy of the skin has shown that 6 treatment sessions of Multisource RF technology improve skin structure features. The skin after treatment had longer and narrower dermal papilla and denser and finer collagen fiber typical to younger skin as compared to pre treatment skin. Ultrasound of the skin showed after 6 treatment sessions reduction of 10 percent in the thickness of the subcutaneous fat layer. Non ablative facial clinical studies showed a significant reduction of wrinkles after treatment further reduced at 3 months follow-up. Body treatment studies showed a circumference reduction of 2.9 cm immediately after 6 treatments, and 2 cm at 12 months after the end of treatment, proving long term collagen remodeling effect. Clinical studies of the multisource fractional RF application have shown significant effects on wrinkles reduction and deep atrophic acne scars after 1-3 treatment sessions.