Since Endre Mester's initial reports on the application of low-incident energy laser radiation for the successful therapy of treatment-resistant torpid crural ulcers, many other reports have appeared in the literature on the success of laser therapy in many aspects of wound healing. The semiconductor diode laser, helium-neon (HeNe) laser, neodymium yttrium aluminium garnet (Nd:YAG) laser, carbon dioxide (CO2) laser and ruby laser have appeared in various reports as having a good effect on abnormally-healing wounds. We report in this paper on a late-middle-aged male patient with a therapy-resistant lower extremity ulcer, diagnosed as diabetic arteriosclerosis obliterans. Despite two months as an inpatient and a variety of therapeutic modalities, including infrared diode laser (GaAlAs, 60 mW c/w, power density of approximately 3 W/cm2), the ulcer failed to heal. HeNe LLLT was then started (8.5 mW c/w, scanned mode, power density 27 W/cm2), twice per day, 10 minutes per session. After one month, considerable improvement was seen in both healing and pain removal, and the ulcer had healed completely after five months, with complete pain removal. It is suggested that, for open wounds requiring direct irradiation to the wound bed, the HeNe laser at 632.8 nm is most effective, applied in the noncontact scanning mode.
Advances in the application of low reactive-level laser therapy (LLLT) in the treatment of rheumatologic disease entities are presented from the author's experience in a major rheumatology centre in Cologne, Germany. The literature is reviewed, showing clear evidence for the effectiveness of LLLT in this field. An uncontrolled clinical study on the effectiveness of LLLT using a 904 nm diode GaAs laser and a mixed 904 nm and 632.8 nm (HeNe) laser in the treatment of intractable chronic tendinopathies is reported, with effective rates well over 80% for pain both at rest and in motion. Mild and reversible side effects, which may , double-blind cross-over study on the effectiveness of LLLT for advanced (stage III-IV) ankylosing spondylarthritis using a mix of 904 nm and 632.8 nm laser energy gave effective pain attenuation, with significantly higher effectiveness shown by real as compared with sham LLLT. There was no significant effect on either laboratory tests or on spinal ROM. The effective rate for conventional chemotherapeutic agents, non steroid anti-inflammatory drugs (NSAIDs) is seen in the literature as high as 85%, but the side-effects are many and serious, even resulting in a very small percentage of cases in death. Although more research into actual mechanisms and pathways is needed, LLLT is presented as a safe, noninvasive, easy to apply and comparatively side-effect free modality offering the clinical rheumatologist an effective tool in the treatment of therapy-resistant rheurnatologic disease entities.
We have applied unilateral stellate ganglion block (SGB) and low reactive-level laser therapy (LLLT) on the contralateral stellate ganglion as a treatment for allergic rhinitis. At the early stage of treatment, a remarkable improvement in the patient's condition was recognized. It is suggested that this combination of low reactive-level laser therapy and stellate ganglion block treatment is effective from the point of minimizing side effects from SGB, for shortening the period of treatment duration and giving an overall better result than SGB alone. Further definitive studies are required before this therapeutic method can be recommended as a matter of course, but the preliminary findings are very promising.
From 1983, out of 4500 pain patients treated at the Ohshiro clinic, 1500 had lumbago-related disease entities. From 1987 until the present, a period of 61 months, 524 patients with a variety of lumbar diseases received low reactive-level laser therapy, LLLT, using the GaAlAs diode laser (830 nm, 60 mW, continuous wave). There were 364 males and 160 females (M:F-2.3:1), with an average age of 53.7 years (M: 53.7, F: 47.5). The laser was applied in the pressure contact technique at a variety of treatment times, using Ohshiro's proximal priority method. The patients graded the effectiveness of their therapy into four grades, from excellent to poor: the sum of the first two grades was used to assess the overall efficacy rate. Patients were interviewed immediately before and after the first therapy session, to give the immediate effect, and at one week after the final session, to elucidate the delayed LLLT effect. Some of the patients (81.6%) reported excellent or good immediate results, and 82% gave the same assessment for the delayed effect. No side-effects at all were reported, and patients have maintained the effective results during the follow-up period. The authors conclude that LLLT with the GaAlAs diode laser at the parameters as reported affords an easily applied, noninvasive, effective and safe therapeutic method for the treatment of pain entities in the lumbago group. Further controlled studies are needed to research in detail the possible mechanisms and pathways, although some are already known.
The strawberry haemangioma is a disturbing lesion, especially for the parents of the affected infant. Surgical intervention is unacceptable in most cases, owing to the possibility of severe scarring. Reports have appeared on successful application of laser surgery (HLLT) for smaller lesions, but the possibility of scarring still exists. Because of the success of Low reactive-Level Laser Therapy (LLLT) in promoting circulatory improvement, and photobioactivation of the fibroblast to encourage synthesis of normal collagen, the authors started applying 830 nm diode LLLT (60 mW, 5 s per point) at points around the periphery of the lesion, at a point density of 1 per 10 cm2 of the lesion. The results have been excellent in 20 cases treated exclusively with LLLT to date, with speedy regression, restoration of normal colour and configuration, and return to a normal skin texture. Although most strawberry haemangiomata regress spontaneously within 7 years, especially in the larger lesions there is a strong possibility of some remaining colour and configurational abnormality, coupled with abnormal skin texture. Using LLLT, the authors have found that full regression is usually obtained within approximately 4 years maximum, with little or no remaining colour and configurational abnormality. With LLLT, it is possible to restore the elasticity and firmness to the hamartomatous haemangioma tissue, by normalizing the collagen and elastin fibre matrices, and replacing the deeper cavernous component of the lesion. LLLT is totally noninvasive, and well-tolerated in the younger patient. Case reports are presented, and a discussion of the mechanism and timing of the therapy is given.
The fourth annual meeting of the Japan Laser Therapy Association (JaLTA) was held recently on 4 and 5 July in the University of Hokkaido, Sapporo City, Japan, under the Presidency of Professor Osamu Kemmotsu of the Department of Anaesthesia, Hokkaido University School of Medicine. This report on the meeting is prepared and presented to allow those not able to be present to assess the quality of research into, and development of LLLT and photobioactivation in Japan. The scope of the meeting and the quality of the papers were excellent. The reviewer hopes to see a good number of them in future editions of Laser Therapy, but in English!