Online ISSN : 1884-7269
Print ISSN : 0898-5901
ISSN-L : 0898-5901
21 巻, 2 号
Kaplan’s Corner
Original Article
  • Toshio Ohshiro
    2012 年 21 巻 2 号 p. 97-103
    発行日: 2012年
    公開日: 2012/07/03
    ジャーナル フリー
    Background and Aims: The rapidly graying population in Japan is being compounded by the rapidly-dropping birth rate. The latter is mostly due to the later ages at which women are giving birth as the marriage age has also been increasing. Giving birth at a later stage is associated with problems for both mother and child, but for older would-be mothers the greatest problem is infertility, sometimes severe. The present article will show how the application of low level laser therapy (LLLT) is a potentially effective treatment for severe infertility.
    Subjects and Methods: Seventy-four females (average age 39.28 yr) with severe infertility in whom assisted reproductive technology (ART) had been unsuccessful (average of 9.13 yr) participated in the first part of a study from October 1996 . April 2000. LLLT was applied (830 nm, CW, GaAlAs 60 mW diode LLLT) in Ohshiro’s proximal priority technique (average 21.08 sessions) with or without other ART approaches. Based on successful outcomes, the study was then extended to March 2012, amassing a final total of 701 patients.
    Results: Pregnancy was achieved in the first part of the trial in 16 patients (21.7% of 74) of whom 11 (68%) achieved successful live delivery. In the extended trial, pregnancy was achieved in 156 (22.3% of 701) with 79 live deliveries (50.1%).
    Conclusions: The use of 830 nm LLLT in the proximal priority technique at the parameters used in the present study, on its own or as an adjunct to other techniques, resulted in successful induction of pregnancy in just over 21% of severely infertile females, with a substantial number of these achieving live births. No adverse events were noted in any patient. LLLT is a pain-free and sideeffect free modality which could give hope to the increasing numbers of older females with infertility in Japan and potentially worldwide. Multinational studies are warranted.
  • Geun-Soo Lee
    2012 年 21 巻 2 号 p. 105-111
    発行日: 2012年
    公開日: 2012/07/03
    ジャーナル フリー
    Background and aims: Acne remains a severe problem for both patients and clinicians. Various approaches using photosurgery and phototherapy have been reported with varying degrees of success and robustness of results. An improved intense pulsed light (IPL) system has become available with interesting beam characteristic which might improve IPL treatment of inflammatory acne in the Asian skin, Fitzpatrick type III/IV.
    Subjects and Methods: The 18 study subjects comprised 15 females and 3 males with active mild to moderately severe inflammatory acne (mean age 25.3 ± 7.70 yr, range 17-47 yr, Burton scale 1-4, all Fitzpatrick type III Asian skin). They were treated once (8 subjects) or twice (10 subjects) with an IPL system offering both square pulse and time resolved spectral distribution technologies (420 nm cut-off filter, 30 ms pulse, 8 - 12 J/cm2, 2-3 passes). Clinical photography was taken at baseline and at 4 weeks after the final treatment. Percentage of acne clearance was assessed by an independent dermatological panel and graded from zero to 5, 5 being total clearance.
    Results: All subjects completed the study. Post-treatment side effects were mild and transient, with virtually no downtime or postinflammatory hyperpigmentation (PIH) experienced by any subject. All subjects had some improvement and no exacerbation was seen in any subject. Clearance was evaluated by the panel as grade 4 in 5 subjects, grade 3 in 8, grade 2 in 4 and grade 1 in 1, so that 14 of 18 subjects (78%) had clearance of at least 60%. Patient evaluation was in general slightly better than that of the panel.
    Conclusions: The special beam characteristics of the IPL system used in the present preliminary study achieved good to very good results in the treatment of acne in the Fitzpatrick type III Asian skin without PIH induction. The results suggested that acne treatment in the Asian skin using this system is both safe and effective, and merits larger population studies to further optimize parameters and standardize top-up treatments.
  • Tokuya Omi
    2012 年 21 巻 2 号 p. 113-123
    発行日: 2012年
    公開日: 2012/07/03
    ジャーナル フリー
    Background and Aims: Recent reports indicate that a variety of light-based devices have been used for acne treatment and skin rejuvenation. A new technology combining intense pulsed light with negative pressure, photopneumatic technology, has recently attracted interest. The present study assessed acne treatment and skin rejuvenation with this novel approach
    Subjects and Methods: Acne, 450 nm tip. Five Japanese volunteers (1 male, 4 female; mean age 28.6 yr; skin type III) with mild to moderate/moderate active acne participated. The face was treated with 2 sessions, 2 weeks apart. Biopsies were obtained immediately after the first session and 1 week after the second session, and routinely processed for transmission electron microscopy (TEM). Rejuvenation, profusion tip with topical preparation. In 5 Japanese volunteers (3 male, 2 female; mean age 37.6 yr, skin type III), the volar aspect of both forearms was treated with the 530 nm head at P6 (around 12 J/cm2). The left arm was then treated with a pre-infused profusion tip and vacuum only. Four sessions were given, 14-day intervals. Biopsies were taken from both arms 2 weeks after the 2nd session and 3 weeks after the 4th session. One-half of each biopsy was assessed with histo- and immunohistochemistry, and the other with TEM.
    Acne trial: A combination of physical extraction of comedones, mild photothermal damage of the follicle and damage to identified bacilli was noted post-treatment, with macroscopic improvement of the skin. Rejuvenation with profusion: Significant morphological and immunohistochemical differences were seen between the control and profusion-treated arms at the first assessment. These differences became less significant at the 2nd assessment.
    Macroscopically and histologically, photopneumatic technology improved acne lesions, suggesting a synergistic effect between the components of the technology. In skin rejuvenation, the profusion therapy accelerated the regenerative process, and could have excellent additional potential as a noninvasive transepidermal drug delivery system.
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