Background and aims: Carpal tunnel syndrome is the most prevalent peripheral neuropathy and has a considerable burden on health services. We tried to compare the therapeutic effects of local corticosteroid injection, low-level laser, and corticosteroid phonophoresis in the treatment of carpal tunnel syndrome. Subjects and methods: We performed a randomized clinical trial with three parallel groups. The study was carried out at a University Hospital. In total, 42 participants including 31(73.8%) women were randomly allocated to the treatment groups with equal sizes. We assessed pain, symptom severity and functional status with Boston Carpal Tunnel Questionnaire, and performed median nerve conduction velocity studies. Evaluations were done before the interventions and in the fourth week of study. For the group corticosteroid, under the guidance of sonography, methylprednisolone with lidocaine was injected into the carpal tunnel. For laser therapy, we administered 10 sessions, each lasting 10 seconds. We used topical hydrocortisone acetate gel 10% as the anti-inflammatory agent with phonophoresis, 3 times per week for 10 sessions. Results: Within-group analyses with paired t-test showed that local corticosteroid, laser, and phonophoresis are all effective treatments. Between-group analyses with ANOVA indicated that there were significant differences among the groups after four weeks in terms of pain (p = 0.004), in favor of corticosteroid; and in sensory delay (p = 0.001), in favor of laser. For the Boston Carpal Tunnel Questionnaire and median nerve motor latency, the results were not significant. There was no important side-effect after four weeks of follow-up. Conclusion: The three treatments are comparable and beneficial for carpal tunnel syndrome.
Background and Aims: Helicobacter pylori (H. pylori) eradication has become increasingly unsuccessful due to the prevalence of antibiotic resistance. To address this global issue, a novel strategy for eradication without antibiotics must be developed. The purpose of this study was to examine the effect of methylene blue (MB) with sodium bicarbonate (NaHCO3) on H. pylori using photodynamic antimicrobial chemotherapy. Materials and Methods: MB was basified using NaHCO3. The basic effect of MB with NaHCO3 was examined using an endoscope equipped with a laser light source. H. pylori was smeared on the culture media with basic MB, followed by illumination at approximately 1,100 lux for 10 and 20 seconds. After 4 days of culture, the basic effects were determined according to the bacterial growth. Results: The basic effects of MB appeared at a pH from 8.6 to 9.0 and at NaHCO3 concentrations between 2% and 6.5%. MB concentrations of > 0.05% exhibited the basic effects. The duration of irradiation had no remarkable effects. Conclusions: Our results showed that the laser endoscope and basic MB were effective for H. pylori eradication.
Background: The aim of the study was to compare the clinical and radiographic evaluation of pulpotomy using mineral trioxide aggregate (MTA), calcium silicate-based cement (Biodentine), and Er,Cr:YSGG laser in primary molars. Materials and methods: Fifty-four primary teeth were selected for this study as per the inclusion and exclusion criteria in the age group of 4-9 years and then randomly allocated to three groups A, B & C. In group A, after removal of coronal pulp, MTA was placed at the floor of pulp chamber. In group B, calcium silicate-based cement (Biodentine) was placed at the floor of pulp chamber. In group C, decontamination of the cavity was done with Er,Cr:YSGG laser. This was followed by placement of permanent restorative material in all the groups. Clinical and radiographic success was evaluated at 3, 6 and 9 months. Data analysis was performed using Statistical Package for the Social Science-21 (SPSS-21). Results: At the end of 9 months, overall success rate of pulpotomy was 85.5%. There was no significant difference among the three groups (p > 0.05). Conclusion: The study showed that the success of pulpotomy procedure is independent of the type of medicament used for pulpotomy. Moreover, the study also shows that Er,Cr:YSGG laser can be effectively used for pulpotomy procedures.
Background: Chronic sinusitis is one of the most common chronic diseases involving different age groups. The different etiological factors and difficult diagnostic procedures contribute to misdiagnosis and chronicity of sinusitis. There is no standard treatment for sinusitis. Long term use of corticosteroids and antibiotics may lead to numerous adverse side effects. Laser therapy has been suggested as a non-invasive treatment for sinusitis. It has anti-inflammatory and antibacterial effects. When considering maxillary sinusitis, discharge tends to collect in the sinus base due to its anatomy and altered physiology. To improve penetration of laser into the maxillary sinus, intraoral laser at the vestibule depth of the maxilla may be more effective. Material and Subject: Thirty-four patients with chronic maxillary sinusitis were assigned into two groups. All were assessed before and after treatment. Group A received laser radiation plus standard medical treatment and group B received medical treatment only. The treatment plan was performed in 12 sessions using a Diode laser with a wavelength of 810 nm and 980nm. The SNOT-22 questionnaire and Computed Tomography were used to evaluate patients. A p-value < 0.05 was considered statistically significant. Results: Both groups showed a significant improvement in symptoms following treatment (p < .001), however, the laser therapy group demonstrated greater improvements for all variables in response to treatment as compared to the traditional treatment group (p < .001). Conclusions: Using high intensity intra-oral laser therapy with medical treatment is more effective than using medical treatment only for treatment of chronic maxillary sinusitis.
Background and aims: Muscle hardness causes lower activity in athletic practice or sport competition. Increase in muscle hardness often cause injury and muscle fatigue. The aim of this study is to investigate the effect on muscle hardness of acupuncture stimulation using low-reactive level laser therapy (LLLT) and silver spike point (SSP) therapy, along with stimulation by stretching. Materials (Subjects) and Methods: Muscle fatigue was created experimentally, and the effect of LLLT was examined with the indices of muscle hardness and the pennation angle, using ultrasound diagnostic equipment with real-time tissue elastography (RTE) functionality. Results: As a result, a combined use of stretching and SSP therapy was effective on muscle hardness, while LLLT alone had no immediate lowering of muscle hardness. In addition, only the laser stretching group demonstrated a significant decrease in the pennation angle. Conclusions: This is because an improved local blood flow due to SSP therapy is considered to have relaxed muscle tonus, which boosted metabolism and removed algogenic substances. This became more effective through a combined use of stretching and low-power laser irradiation. Moreover, it was suggested that stimulation of the acupuncture points in the crus could have a further effect on muscle hardness and the pennation angle.
Background and Aims: Although, the pulse width should be shorter than the thermal relaxation time of the target, nanosecond laser pulses are not short enough for tattoo removal. Complications are common, such as hyper or hypopigmentation, textural changes, and scarring. Moreover, patients with darker skin types are at a higher risk of complications from tattoo removal using these lasers. Picosecond lasers were developed to overcome the limitation of nanosecond lasers. We did a comparison study of a 532/1064 nm picosecond laser vs a 532/1064 nm nanosecond laser to evaluate the clinical efficacy and complications of multi-color tattoos in Asians. Materials and Methods: Eleven Asian patients with 37 professional tattoos were enrolled in the study. Each patient was treated with a 532/1064 nm nanosecond laser and a 532/1064 nm picosecond laser. The spot size that was used with each laser was 3 mm. Four treatments were performed, with four week intervals between each treatment. Patients were examined a week after the first treatment and 3 months after the last treatment. Results and Conclusions: All patients tolerated the treatments well. The efficacy of the 1064 nm picosecond laser for black tattoos is significantly better than the other studied lasers. The efficacy of the 532 nm picosecond laser is significantly better than the other studied lasers for red tattoos. The efficacy of the 532 nm picosecond laser is significantly better than the 532 nm nanosecond laser and better than the 1064 nm picosecond laser for green tattoos. Mild to moderate post-inflammatory hyperpigmentation was observed in 35.1%, 24.3% 27.0%, and 21.6% of the tattoos treated with the 532 nm nanosecond laser, the 532 nm picosecond laser, the 1064 nm nanosecond laser, and the 1064 nm pico-second laser, respectively. Paradoxical darkening (5.4%) was observed equally with each type of laser. There was no scar formation in any of the tattoos treated. The 532/1064 nm picosecond laser is more effective than the 532/1064 nm nanosecond laser in the treatment of multi-color tattoos in Asians. The 532 nm picosecond laser is more effective than 1064 nm picosecond laser in every tattoo color, with the exception of black. Paradoxical darkening was observed, even the use of picosecond lasers.
Background and Aims: Rejuvenation therapy using picosecond pulse laser and picosecond pulsed fractional therapy with a fractional lens have been performed with clinical effects evaluated. However, no histological analysis of effects on photoaged skin exists. In this study, influence of laser-toning and fractional therapy using picosecond pulse laser on photoaging was histologically investigated. Subjects and Methods: The flexor side forearm of a male, age 61, with photoaging was divided into three 20 cm² areas and irradiated with approximately 400 shots of 10-Hz laser, 8 mm spot size, and nine passes at an output of 0.7, 0.9, and 1.1 J/cm² using picosecond laser-toning therapy six times, every two weeks. Two weeks post final irradiation, 2 mm punch biopsies were taken from the irradiation fields. Fractional therapy using Micro Lens Array (MLA) attached picosecond fractional therapy was applied to the medial crural skin with marked photoaging of a male, age 63. Irradiation was applied at 0.5 and 0.7 J/cm² through two passes, with 3 mm punch biopsies taken from each irradiation field immediately after and again two months post-irradiation. Samples were subjected to hematoxylin and eosin (HE) and Elastica van Gieson staining and compared. Results: In the picosecond laser-toning therapy sample, photoaging-induced dermis reconstruction occurred. The picosecond fractional therapy sample showed both epidermis and dermis reconstruction, with intrinsic aging and photoaging improvements. Conclusions: Recovery of dermal and epidermal age related atrophy by picosecond laser-toning and picosecond fractional therapy was histologically confirmed. Picosecond fractional therapy demonstrated superior improvement.
Background and Objectives: Computational clinical trial (CCT) in the field of laser medicine promotes clinical application of novel laser devices, because this trial carried out based on numerical modeling of laser-tissue interactions and simulation of a series of treatment process. To confirm the feasibility of the computational clinical trial of skin treatment with a novel picosecond laser, this paper presents an evaluation method of the safety. Study Design/Materials and Methods: In this method, the light propagation and thermal diffusion process after ultrashort light pulse irradiation to a numerical skin model is calculated and the safety based on the photothermal damage is evaluated by computational modeling and simulation. As an example, the safety of a novel picosecond laser device was examined by comparing with several laser devices approved for clinical use. Results: The ratio of the maximum thermal damage induced by picosecond laser irradiation was 1.2 × 10-2 % at the epidermis, while that caused by approved laser irradiation was 99 % at the capillary vessels. The numerical simulation demonstrated that less thermal damage was observed compared with the approved devices. The results show the safety simulated by photothermal damage calculation was consistent with the reported clinical trials. Conclusions: This computational clinical trial shows the feasibility of applying computational clinical trials for the safety evaluation of novel medical laser devices. In contrast to preclinical and clinical tests, the proposed computational method offers regulatory science for appropriately and quickly predicting and evaluating the safety of a novel laser device.
The possibility of using photoacoustic imaging for functional diagnosis has attracted much attention especially in the clinical field. Among such imaging systems, a system, which offers real-time imaging using compact and low-priced LEDs as a light source, has appeared. Compared to solid state lasers, the LED pulse energy was extremely small, so it had been thought that imaging would be extremely difficult, but by adding a pre-amplifier, real time photoacoustic imaging became possible. However the signal-to-noise ratio (SNR) and the amplifier gain needed for making real time imaging possible have remained unclear. The present study was designed to clarify these data. The results showed that, using a tissue phantom and human fingers, an SNR > 4 and amplifier gain > 80dB were required, and demonstrated why making an image without a pre-amplifier had proved difficult.
Apocrine hidrocystomas are benign, cystic tumours arising from the apocrine sweat gland. They usually present as a solitary papule or nodule in the periorbital area and it is uncommon for multiple lesions to appear. We present a case of multiple apocrine hidrocystomas on the nasal dorsum which became apparent after ablative laser treatment. We also review the literature for apocrine hidrocystoma, including their clinical presentation, histopathological findings and treatment options.