Optimal Laser Phototherapy Parameters for Pain Relief.
Photomed Laser Surg. 2018 Mar 27. Epub 2018 Mar 27. PMID: 29583080
Rohit J Kate, Sarah Rubatt, Chukuka S Enwemeka, Wendy E Huddleston
Rohit J Kate
BACKGROUND AND OBJECTIVE: Studies on laser phototherapy for pain relief have used parameters that vary widely and have reported varying outcomes. The purpose of this study was to determine the optimal parameter ranges of laser phototherapy for pain relief by analyzing data aggregated from existing primary literature.
MATERIALS AND METHODS: Original studies were gathered from available sources and were screened to meet the pre-established inclusion criteria. The included articles were then subjected to meta-analysis using Cohen's d statistic for determining treatment effect size. From these studies, ranges of the reported parameters that always resulted into large effect sizes were determined. These optimal ranges were evaluated for their accuracy using leave-one-article-out cross-validation procedure.
RESULTS: A total of 96 articles met the inclusion criteria for meta-analysis and yielded 232 effect sizes. The average effect size was highly significant: d = +1.36 (confidence interval [95% CI] = 1.04-1.68). Among all the parameters, total energy was found to have the greatest effect on pain relief and had the most prominent optimal ranges of 120-162 and 15.36-20.16 J, which always resulted in large effect sizes. The cross-validation accuracy of the optimal ranges for total energy was 68.57% (95% CI = 53.19-83.97). Fewer and less-prominent optimal ranges were obtained for the energy density and duration parameters. None of the remaining parameters was found to be independently related to pain relief outcomes.
CONCLUSIONS: The findings of meta-analysis indicate that laser phototherapy is highly effective for pain relief. Based on the analysis of parameters, total energy can be optimized to yield the largest effect on pain relief.
Article Published Date : Mar 26, 2018
Recurrent aphthous stomatitis and pain management with low-level laser therapy: a randomized controlled trial.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 May ;117(5):590-4. Epub 2014 Feb 6. PMID: 24725989
Margit Albrektson, Lennart Hedström, Håkan Bergh
OBJECTIVE: The aim of the study was to determine whether low-level laser therapy (LLLT) has an analgesic effect in patients with recurrent aphthous stomatitis (RAS).
STUDY DESIGN: A randomized single-blinded placebo-controlled trial was conducted with LLLT (wavelength, 809 nm; power, 60 mW; pulse frequency, 1800 Hz; duration, 80 seconds per treatment; dose, 6.3 J/cm(2)) in 40 patients with RAS. The intervention group was treated with LLLT on 3 occasions, with a 1-day interval. The control group was treated similarly, without any laser power. Pain perception (visual analog scale [VAS] rating) and patients' experience of eating, drinking, and brushing teeth was registered.
RESULTS: VAS rating decreased (day 0 until day 2) from 84.7 to 31.5 (LLLT) and from 81.7 to 76.1 (placebo) (P<.0001). LLLT also relieved the difficulty of drinking, eating, and brushing teeth.
CONCLUSIONS: LLLT reduced the pain and the inconvenience of eating, drinking, and brushing teeth for patients with RAS, compared with placebo.
Article Published Date : Apr 30, 2014
Complementary treatment with oral pidotimod plus vitamin C after laser vaporization for female genital warts: a prospective study.
J Med Life. 2010 Jul-Sep;3(3):286-8. PMID: 20945819
S Zervoudis, G Iatrakis, P Peitsidis, A Peitsidou, L Papandonopolos, M K Nikolopoulou, L Papadopoulos, R Vladareanu
This is a prospective study to assess a complementary treatment for genital warts after laser vaporization. 62 patients were enrolled in two randomized groups: Al: laser vaporization alone. A2: laser vaporization, followed with Pidotimod plus vitamin C for 2 1/2 months. The latter treatment shortened the time of warts remission and marginally decreased the rate of the warts' recurrence: 81% versus 67% (N.S.). Despite the non-significant difference, this complementary treatment seems to have some efficiency.
Article Published Date : Jul 01, 2010
The use of low-level light for hair growth: part I.
J Cosmet Laser Ther. 2009 Jun;11(2):110-7. PMID: 19466643
Marc R Avram, Nicole E Rogers
BACKGROUND AND OBJECTIVE: Low-level laser therapy (LLLT) is a new therapy for the treatment of hair loss. It has received enormous media attention and tremendous marketing budgets from companies that sell the devices, but no independent, peer-reviewed studies have demonstrated its efficacy in this application. Here we investigate the efficacy of LLLT in enhancing hair growth. METHODS: A total of seven patients were exposed to LLLT twice weekly for 20 minutes each time over a period of 3-6 months. Five patients were treated for a total of 3 months and two were treated for 6 months. Videomicroscopic images were taken at baseline, 3 months, and 6 months, and analyzed for changes in vellus hair counts, terminal hair counts, and shaft diameter. Both videomicroscopic and global images underwent blinded review for evidence of subjective improvement. Patients also answered questionnaires assessing hair growth throughout the study. Neither patients nor physicians conducting the study received any financial compensation. RESULTS: The results indicate that on average patients had a decrease in the number of vellus hairs, an increase in the number of terminal hairs, and an increase in shaft diameter. However, paired i-testing indicated that none of these changes was statistically significant. Also, blinded evaluation of global images did not support an improvement in hair density or caliber. CONCLUSIONS: LLLT may be a promising treatment option for patients who do not respond to either finasteride or minoxidil, and who do not want to undergo hair transplantation. This technology appears to work better for some people than for others. Factors predicting who will most benefit are yet to be determined. Larger, longer-term placebo-controlled studies are needed to confirm these findings, and demonstrate statistical significance, or refute them altogether.
Article Published Date : Jun 01, 2009
Low-intensity laser therapy is an effective treatment for recurrent herpes simplex infection. Results from a randomized double-blind placebo-controlled study.
Glia. 2009 Mar;57(4):402-13. PMID: 10469307
A Schindl, R Neumann
Recurrent infection with herpes simplex virus is a common disease. Recently, alternative therapies have been introduced. Among those, low-intensity laser therapy mainly used for the acceleration of wound healing and in pain therapy has previously been shown to be of benefit in herpes zoster infections. In this study we evaluated the influence of low-intensity laser therapy (wavelength 690 nm, intensity: 80 mW per cm2, dose: 48 J per cm2) in 50 patients with recurrent perioral herpes simplex infection (at least once per month for more than 6 mo) in a randomized, double-blind placebo-controlled trial design. Patients in the laser group received daily irradiations for 2 wk, whereas patients in the placebo group were sham-irradiated. After completion of the laser/sham treatment, patients were asked to return to the Department of Dermatology, University of Vienna Medical School at the time of recurrence. All except two patients completed the study and were monitored for 52 wk. The median recurrence-free interval in the laser-treated group was 37.5 wk (range: 2-52 wk) and in the placebo group 3 wk (range: 1-20 wk). This difference was found to be statistically significant (p<0.0001; Wilcoxon's Rank Sum Test). In conclusion, we demonstrated that a total of 10 irradiations with low-intensity laser therapy significantly lowers the incidence of local recurrence of herpes simplex infection. Since this athermic phototherapeutic modality represents a safe, noninvasive treatment, it might be considered as an alternative to established therapeutic regimens in this indication.
Article Published Date : Mar 01, 2009
Phototherapy in peripheral nerve regeneration: From basic science to clinical study.
Neurosurg Focus. 2009 Feb;26(2):E8. PMID: 19199510
OBJECT: This review summarizes the continuous study of low-power laser radiation treatment of a severely injured peripheral nerve. Laser phototherapy was applied as a supportive factor for accelerating and enhancing axonal growth and regeneration after injury or a reconstructive peripheral nerve procedure. In nerve cell cultures, laser phototherapy was used to stimulate activation of nerve cells.
METHODS: Low-power laser radiation was used for treatment of peripheral nerve injury using a rat sciatic nerve model after crush injury, neurorrhaphy, or neurotube reconstruction. Nerve cell growth and axonal sprouting were investigated using laser phototherapy on embryonic rat brain cultures. The outcome in animal studies facilitated a clinical double-blind, placebo-controlled, randomized study that measured the effectiveness of 780-nm laser phototherapy on patients suffering from incomplete peripheral nerve injuries for 6 months to several years.
RESULTS: Animal studies showed that laser phototherapy has an immediate protective effect, maintains functional activity of the injured nerve, decreases scar tissue formation at the injury site, decreases degeneration in corresponding motor neurons of the spinal cord, and significantly increases axonal growth and myelinization. In cell cultures, laser irradiation accelerates migration, nerve cell growth, and fiber sprouting. A pilot clinical double-blind, placebocontrolled, randomized study showed that in patients with incomplete long-term peripheral nerve injury, 780-nm laser radiation can progressively improve peripheral nerve function, which leads to significant functional recovery.
CONCLUSIONS: Using 780-nm laser phototherapy accelerates and enhances axonal growth and regeneration after injury or a reconstructive peripheral nerve procedure. Laser activation of nerve cells, their growth, and axonal sprouting can be considered as potential treatment of neuronal injury. Animal and clinical studies show the promoting action of phototherapy on peripheral nerve regeneration, making it possible to suggest that the time for broader clinical trials has arrived.
Article Published Date : Feb 01, 2009
Chapter 25: Phototherapy in peripheral nerve injury: effects on muscle preservation and nerve regeneration.
Int Rev Neurobiol. 2009;87:445-64. PMID: 19682654
Shimon Rochkind, Stefano Geuna, Asher Shainberg
Division of Peripheral Nerve Reconstruction, Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv University, Israel.
Posttraumatic nerve repair and prevention of muscle atrophy represent a major challenge of restorative medicine. Considerable interest exists in the potential therapeutic value of laser phototherapy for restoring or temporarily preventing denervated muscle atrophy as well as enhancing regeneration of severely injured peripheral nerves. Low-power laser irradiation (laser phototherapy) was applied for treatment of rat denervated muscle in order to estimate biochemical transformation on cellular and tissue levels, as well as on rat sciatic nerve model after crush injury, direct or side-to-end anastomosis, and neurotube reconstruction. Nerve cells' growth and axonal sprouting were investigated in embryonic rat brain cultures. The animal outcome allowed clinical double-blind, placebo-controlled randomized study that measured the effectiveness of 780-nm laser phototherapy on patients suffering from incomplete peripheral nerve injuries for 6 months up to several years. In denervated muscles, animal study suggests that the function of denervated muscles can be partially preserved by temporary prevention of denervation-induced biochemical changes. The function of denervated muscles can be restored, not completely but to a very substantial degree, by laser treatment initiated at the earliest possible stage post injury. In peripheral nerve injury, laser phototherapy has an immediate protective effect. It maintains functional activity of the injured nerve for a long period, decreases scar tissue formation at the injury site, decreases degeneration in corresponding motor neurons of the spinal cord, and significantly increases axonal growth and myelinization. In cell cultures, laser irradiation accelerates migration, nerve cell growth, and fiber sprouting. In a pilot, clinical, double-blind, placebo-controlled randomized study in patients with incomplete long-term peripheral nerve injury, 780-nm laser irradiation can progressively improve peripheral nerve function, which leads to significant functional recovery. A 780-nm laser phototherapy temporarily preserves the function of a denervated muscle, and accelerates and enhances axonal growth and regeneration after peripheral nerve injury or reconstructive procedures. Laser activation of nerve cells, their growth, and axonal sprouting can be considered as potential treatment for neural injury. Animal and clinical studies show the promoting action of phototherapy on peripheral nerve regeneration, which makes it possible to suggest that the time for broader clinical trials has come.
Article Published Date : Jan 01, 2009
Efficacy of 780-nm laser phototherapy on peripheral nerve regeneration after neurotube reconstruction procedure (double-blind randomized study).
Photomed Laser Surg. 2007 Jun;25(3):137-43. PMID: 17603852
Shimon Rochkind, Leonor Leider-Trejo, Moshe Nissan, Merav H Shamir, Oleg Kharenko, Malvina Alon
OBJECTIVE: This pilot double-blind randomized study evaluated the efficacy of 780-nm laser phototherapy on the acceleration of axonal growth and regeneration after peripheral nerve reconstruction by polyglycolic acid (PGA) neurotube.
BACKGROUND DATA: The use of a guiding tube for the reconstruction of segmental loss of injured peripheral nerve has some advantages over the regular nerve grafting procedure. Experimental studies have shown that laser phototherapy is effective in influencing nerve regeneration.
METHODS: The right sciatic nerve was transected, and a 0.5-cm nerve segment was removed in 20 rats. A neurotube was placed between the proximal and the distal parts of the nerve for reconnection of nerve defect. Ten of 20 rats received post-operative, transcutaneous, 200-mW, 780-nm laser irradiation for 14 consecutive days to the corresponding segments of the spinal cord (15 min) and to the reconstructed nerve (15 min).
RESULTS: At 3 months after surgery, positive somato-sensory evoked responses were found in 70% of the irradiated rats (p = 0.015), compared to 30% of the non-irradiated rats. The Sciatic Functional Index in the irradiated group was higher than in the non-irradiated group (p<0.05). Morphologically, the nerves were completely reconnected in both groups, but the laser-treated group showed an increased total number of myelinated axons.
CONCLUSION: The results of this study suggest that postoperative 780-nm laser phototherapy enhances the regenerative process of the peripheral nerve after reconnection of the nerve defect using a PGA neurotube.
Article Published Date : Jun 01, 2007
low-level laser therapy applied transcranially to mice following traumatic brain injury significantly reduces long-term neurological deficits.
J Neurotrauma. 2007 Apr;24(4):651-6. PMID: 17439348
Amir Oron, Uri Oron, Jackson Streeter, Luis de Taboada, Alexander Alexandrovich, Victoria Trembovler, Esther Shohami
Low-level laser therapy (LLLT) has been evaluated in this study as a potential therapy for traumatic brain injury (TBI). LLLT has been found to modulate various biological processes. Following TBI in mice, we assessed the hypothesis that LLLT might have a beneficial effect on their neurobehavioral and histological outcome. TBI was induced by a weight-drop device, and motor function was assessed 1 h post-trauma using a neurological severity score (NSS). Mice were then divided into three groups of eight mice each: one control group that received a sham LLLT procedure and was not irradiated; and two groups that received LLLT at two different doses (10 and 20 mW/cm(2) ) transcranially. An 808-nm Ga-As diode laser was employed transcranially 4 h post-trauma to illuminate the entire cortex of the brain. Motor function was assessed up to 4 weeks, and lesion volume was measured. There were no significant changes in NSS at 24 and 48 h between the laser-treated and non-treated mice. Yet, from 5 days and up to 28 days, the NSS of the laser-treated mice were significantly lower (p<0.05) than the traumatized control mice that were not treated with the laser. The lesion volume of the laser treated mice was significantly lower (1.4%) than the non-treated group (12.1%). Our data suggest that a non-invasive transcranial application of LLLT given 4 h following TBI provides a significant long-term functional neurological benefit. Further confirmatory trials are warranted.
Article Published Date : Apr 01, 2007
Low-level laser therapy applied transcranially to rats after induction of stroke significantly reduces long-term neurological deficits.
Stroke. 2006 Oct;37(10):2620-4. Epub 2006 Aug 31. PMID: 16946145
Amir Oron, Uri Oron, Jieli Chen, Anda Eilam, Chunling Zhang, Menachem Sadeh, Yair Lampl, Jackson Streeter, Luis DeTaboada, Michael Chopp
BACKGROUND AND PURPOSE: Low-level laser therapy (LLLT) modulates various biological processes. In the present study, we assessed the hypothesis that LLLT after induction of stroke may have a beneficial effect on ischemic brain tissue.
METHODS: Two sets of experiments were performed. Stroke was induced in rats by (1) permanent occlusion of the middle cerebral artery through a craniotomy or (2) insertion of a filament. After induction of stroke, a battery of neurological and functional tests (neurological score, adhesive removal) was performed. Four and 24 hours poststroke, a Ga-As diode laser was used transcranially to illuminate the hemisphere contralateral to the stroke at a power density of 7.5 mW/cm2.
RESULTS: In both models of stroke, LLLT significantly reduced neurological deficits when applied 24 hours poststroke. Application of the laser at 4 hours poststroke did not affect the neurological outcome of the stroke-induced rats as compared with controls. There was no statistically significant difference in the stroke lesion area between control and laser-irradiated rats. The number of newly formed neuronal cells, assessed by double immunoreactivity to bromodeoxyuridine and tubulin isotype III as well as migrating cells (doublecortin immunoactivity), was significantly elevated in the subventricular zone of the hemisphere ipsilateral to the induction of stroke when treated by LLLT.
CONCLUSIONS: Our data suggest that a noninvasive intervention of LLLT issued 24 hours after acute stroke may provide a significant functional benefit with an underlying mechanism possibly being induction of neurogenesis.
Article Published Date : Oct 01, 2006
Treatment of molluscum contagiosum with the pulsed dye laser over a 28-month period.
Cutis. 2003 May;71(5):414-6. PMID: 12769411
John G Hancox, Jeffrey Jackson, Sean McCagh
Although benign, molluscum contagiosum causes cosmetic concern, infection, or transmission to close contacts. Treating patients with multiple lesions, especially children, may be difficult. Complications of treatment include infection, scarring, and limited posttreatment activity. The pulsed dye laser (PDL) has proven safe and effective for the treatment of many skin lesions, but little data exist for its role in the treatment of molluscum contagiosum. The purpose of this study is to describe the use, over a 28-month period, of the 585-nm PDL for the treatment of molluscum contagiosum. The benefits of this treatment are discussed. The charts of 43 patients receiving PDL treatment for molluscum contagiosum between November 1997 and March 2000 were reviewed. Number and location of lesions at initial presentation and on follow-up visits were recorded. Attempts were made to contact patients who were lost to follow-up. All of the approximately 1250 lesions treated resolved, and 35% of patients (n = 15) had no new lesions after 2 treatments. No complications were associated with the procedure. The PDL is a reasonable alternative to traditional treatment modalities for molluscum contagiosum. Benefits to the patient may include prompt response, fewer treatments, and minimal morbidity.
Article Published Date : May 01, 2003
PEGylated mesoporous Bi2S3 Nanostars loaded with Chlorin e6 and doxorubicin for fluorescence/CT imaging-guided multimodal therapy of Cancer.
Nanomedicine. 2019 Jan 14;:
Authors: Sun L, Hou M, Zhang L, Qian D, Yang Q, Xu Z, Kang Y, Xue P
Taking advantage of the mesoporous structure of bismuth sulfide nanostars (Bi2S3 NSs), a chemotherapeutic drug of doxorubicin (DOX) and a photosensitizer of chlorin e6 (Ce6) were concurrently loaded in the PEGylated Bi2S3 NSs to formulate a multifunctional nanocomplex (BPDC NSs) for tumor theranostics. BPDC NSs have excellent photothermal conversion efficiency and a capacity of yielding reactive oxygen species (ROS) upon laser irradiation, and can realize on-demand drug release by either pH-activation or thermal induction. Accumulation of the nanodrug could be monitored in real-time by infrared thermal imaging, fluorescence imaging and computed tomography (CT). More importantly, the combination effects of photothermal therapy (PTT), photodynamic therapy (PDT) and chemotherapy was demonstrated to dramatically suppress solid tumors without recurrence in vivo. Featured by the low systemic toxicity and high biocompatibility, this nanoplatform could be a promising derivative of Bi2S3 NSs for imaging-guided theranostics of cancer.
PMID: 30654184 [PubMed - as supplied by publisher]
Safety and effectiveness of stereotactic laser ablation for epileptogenic cerebral cavernous malformations.
Epilepsia. 2019 Jan 17;:
Authors: Willie JT, Malcolm JG, Stern MA, Lowder LO, Neill SG, Cabaniss BT, Drane DL, Gross RE
OBJECTIVE: Magnetic resonance (MR) thermography-guided laser interstitial thermal therapy, or stereotactic laser ablation (SLA), is a minimally invasive alternative to open surgery for focal epilepsy caused by cerebral cavernous malformations (CCMs). We examined the safety and effectiveness of SLA of epileptogenic CCMs.
METHODS: We retrospectively analyzed 19 consecutive patients who presented with focal seizures associated with a CCM. Each patient underwent SLA of the CCM and adjacent cortex followed by standard clinical and imaging follow-up.
RESULTS: All but one patient had chronic medically refractory epilepsy (median duration 8 years, range 0.5-52 years). Lesions were located in the temporal (13), frontal (five), and parietal (one) lobes. CCMs induced magnetic susceptibility artifacts during thermometry, but perilesional cortex was easily visualized. Fourteen of 17 patients (82%) with >12 months of follow-up achieved Engel class I outcomes, of which 10 (59%) were Engel class IA. Two patients who were not seizure-free from SLA alone became so following intracranial electrode-guided open resection. Delayed postsurgical imaging validated CCM involution (median 83% volume reduction) and ablation of surrounding cortex. Histopathologic examination of one previously ablated CCM following open surgery confirmed obliteration. SLA caused no detectable hemorrhages. Two symptomatic neurologic deficits (visual and motor) were predictable, and neither was permanently disabling.
SIGNIFICANCE: In a consecutive retrospective series, MR thermography-guided SLA was an effective alternative to open surgery for epileptogenic CCM. The approach was free of hemorrhagic complications, and clinically significant neurologic deficits were predictable. SLA presents no barrier to subsequent open surgery when needed.
PMID: 30653657 [PubMed - as supplied by publisher]
Clinical efficacy of low-level laser therapy in plantar fasciitis: A systematic review and meta-analysis.
Medicine (Baltimore). 2019 Jan;98(3):e14088
Authors: Wang W, Jiang W, Tang C, Zhang X, Xiang J
BACKGROUND: Emerging evidence suggests that low-level laser therapy (LLLT) for plantar fasciitis (PF) may be beneficial. However, the convincing study investigating its effectiveness for treatment of PF was scarce. Therefore, a systematic review and meta-analysis was conducted to assess whether LLLT significantly relieve pain of patients with PF.
METHODS: PubMed, EMBASE, EBSCO, Web of Science, China Biological Medicine Database, China National Knowledge Infrastructure, Chinese Wan fang, and Cochrane CENTRAL were searched systematically up to March 2018.
RESULTS: A total of 6 randomized controlled trials were included. The meta-analysis indicated that compared with control group, visual analogue scale (VAS) score significantly decreased at the end point of the treatment in LLLT group. In addition, this improvement is continued for up to 3 months. However, no significant difference was observed according to the Foot Function Index-pain subscale (FFI-p).
CONCLUSION: This meta-analysis indicates that the LLLT in patients with PF significantly relieves the heel pain and the excellent efficacy lasts for 3 months after treatment.
PMID: 30653125 [PubMed - in process]
Multifunctional Screen-Printed TiO2 Nanoparticles Tuned by Laser Irradiation for Flexible and Scalable UV Detector and Room Temperature Ethanol Sensor.
ACS Appl Mater Interfaces. 2019 Jan 17;:
Authors: Dubourg G, Radovic M
Recently, multifunctional devices printed on flexible substrates, with multisensing capability, have found new demand in the practical fields of application such as wearable electronics, soft robotics, interactive interfaces and electronic skin design, revealing the vital importance of precise control of the fundamental properties of metal oxide nanomaterials. In this paper, a novel low-cost and scalable processing strategy is proposed to fabricate all-printed multisensing devices with UV and gas sensing capabilities. Undertaken approach is based on the hierarchical combination of screen-printing process and laser irradiation post-treatment. The screen-printing is used for the patterning of silver interdigitated electrodes and the active layer based on anatase TiO2 nanoparticles while the laser processing is utilized to fine-tune the UV and ethanol sensing properties of the active layer. Different characterization techniques demonstrate that the laser fluence can be adjusted to optimize the morphology of the TiO2 film by increasing the contribution from volume porosity, in order to improve its electrical properties and enhance its UV photoresponse and ethanol sensing characteristics at room temperature. Furthermore, results of the UV and ethanol-sensing investigation show that the optimized UV and ethanol sensors have good repeatability, relatively fast response/recovery times and excellent mechanical flexibility.
PMID: 30652478 [PubMed - as supplied by publisher]
Voice outcome after unilateral ELS type III or bilateral type II resections for T1-T2 glottic carcinoma: Results after 1 year.
Head Neck. 2019 Jan 16;:
Authors: van Loon Y, Hendriksma M, Heijnen BJ, van de Kamp VAH, Hakkesteegt MM, Böhringer S, Langeveld TPM, de Jong MA, Klop WMC, Baatenburg de Jong RJ, Sjögren EV
BACKGROUND: Voice outcome was assessed in patients with extended T1 and limited T2 glottic carcinoma, treated with a unilateral type III or a bilateral type II resection according to the European Laryngological Society (ELS) classification.
METHODS: Objective evaluation (acoustic and aerodynamic parameters), perceptual evaluation (GRBAS), and patients' self-assessment (voice handicap index [VHI]) were performed before and 1 year after treatment. Results were evaluated according to ELS resection type and the involvement of the anterior commissure.
RESULTS: The majority of voice parameters in all resection subgroups showed an improvement of the mean score 1 year postoperatively. Grade of dysphonia varied between 1.15 and 1.66 postoperatively and VHI score varied from 23.3 to 24.5.
CONCLUSION: Voice outcome after ELS unilateral type III or a bilateral type II resection for extended T1 and limited T2 glottic carcinoma is good with mild to very moderate perceptive dysphonia and low self-reported voice impairment.
PMID: 30652373 [PubMed - as supplied by publisher]
Efficacy of panretinal laser in ischemic central retinal vein occlusion: A systematic review.
Exp Ther Med. 2019 Jan;17(1):901-910
Authors: Li C, Wang R, Liu G, Ge Z, Jin D, Ma Y, Liu G
The aim of the present systematic review was to assess the efficacy of laser therapy for ischemic central retinal vein occlusion (CRVO). Relevant studies were retrieved by searching the PubMed, Embase, Chinese Biomedical Literature Database and, Chinese Science and Technology Periodicals databases using a combination of key words, including 'central retinal vein obstruction', 'CRVO', 'laser' and 'panretinal photocoagulation'. The titles, abstracts and full texts were screened by two independent reviewers and studies were selected according to specific inclusion criteria. Data were extracted and the quality of each study was graded using the Grading of Recommendations, Assessment, Development and Evaluation or Methodological Index for Non-Randomized Studies (MINORS) criteria. A total of 1,187 abstracts were retrieved, and finally, 11 clinical studies were selected, including 534 cases of CRVO. Of these, 8 studies compared the efficacy of laser therapy with other treatments for CRVO, two studies compared the efficacy of laser therapy and drug treatment for CRVO and one study compared the efficacy of early laser therapy with standard laser therapy (regular examinations and laser therapy performed as soon as neovascularization was identified) for CRVO. Among them, the results of five studies demonstrated that panretinal photocoagulation (PRP) for the prevention of iris neovascularization and neovascular glaucoma is inefficient regarding the improvement of visual acuity. A total of 10 studies indicated that laser therapy achieved better outcomes in neovascularization of the retina, optic disc neovascularization and iris neovascularization, neovascular glaucoma, vitreous hemorrhage, changes in the visual field, macular edema, macular thickness and intraocular pressure. Of note, it was indicated that laser photocoagulation prevents the severe vascular complications of CRVO. In addition, in the eyes of patients receiving PRP for the treatment of ischemic CRVO, significant reductions in corneal sub-basal nerve plexus parameters and average peripapillary retinal nerve fiber layer thickness were observed. Furthermore, laser photocoagulation was able to increase retinal blood flow in eyes with ischemic CRVO.
PMID: 30651879 [PubMed]
Differential expression of serum proteins in multiple myeloma.
Exp Ther Med. 2019 Jan;17(1):649-656
Authors: Ma TZ, Piao Z, Jin SY, Kwak YG
The exact cause instigating multiple myeloma (MM) has not been fully elucidated, and the disease has a median survival of 6 months without any treatment. To identify potential biomarkers of MM, serum proteins reflecting alteration in their proteomes were analyzed in 6 patients with MM compared with 6 healthy controls using two-dimensional electrophoresis (2-DE) and matrix-assisted laser desorption/ionization time-of flight mass spectrometry. The most notable differentially expressed proteins were validated by immunoblotting and changes in mRNA expression were evaluated by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). A total of 11 differentially expressed protein spots were found. The expression levels of 7 proteins [Immunoglobulin heavy constant µ; proto-oncogene diffuse B-cell lymphoma (DBL2); 26S protease regulatory subunit 4 (P26s4); serum albumin; haptoglobin; and two unknown proteins with isoelectronic point (pI) of 6.41 and molecular weight of 35.4 kDa, and pI of 8.05 and molecular weight of 27.4 kDa, respectively] were downregulated in MM compared with healthy controls. Expression of gel actin-related protein 2/3 complex subunit 1A (ARPC1A); immunoglobulin heavy constant γ 1; fibrinogen α chain (FGA) fragment D; and zinc finger protein 70 were increased in serum of MM patients. Protein expressions of ARPC1A, FGA, P26s4 and DBL2 were measured by immunoblotting in an independent cohort of 12 MM patients and 10 healthy controls. RT-qPCR analysis demonstrated that ARPC1A expression only mimicked protein expression, whereas FGA, PSMC1 (encoding P26s4) and MCF2 (encoding DBL2) did not exhibit significant changes in mRNA expression between control and MM samples. These proteins represent putative serological biomarkers for patients with MM.
PMID: 30651846 [PubMed]
Estimate of incidence of ROP requiring treatment in extreme preterms and impact on service-7 year review in tertiary unit.
Eye (Lond). 2019 Jan 16;:
Authors: Tavassoli S, Wach R, Haynes R, Markham R, Williams C
BACKGROUND/OBJECTIVES: Retinopathy of prematurity (ROP) is a potentially blinding disorder affecting premature infants. Our Eye Unit supports two neonatal intensive care units (NICUs), one provides neonatal surgical and medical facilities and the other is exclusively medical. Our objectives were to (1) to identify the annual rate of ROP treatments during the period 2009-2015 and (2) to estimate the incidence of ROP treatment in babies born very prematurely (<27 weeks).
SUBJECTS/METHODS: Records for all infants treated for ROP by our unit during the period 2009-2015 were reviewed. We calculated numbers treated in each year. Records of babies born under 27 weeks of gestation and cared for in the non-surgical NICU were also reviewed. Their requirement for laser treatments for ROP was calculated by the week of gestation at birth.
RESULTS: In the two NICUs combined, 95 infants were treated for ROP between 2009 and 2015. The numbers treated increased from 9/158 (5.7%) of babies screened in 2009 to 22/159 (13.8%) in 2015 (ptrend = 0.004). The rate of laser treatment for ROP increased as gestation at birth decreased: from 12/100 (12%) of babies born at 26 weeks to 17/29 (59%) of babies born at 23 weeks (ptrend = 0.001).
CONCLUSION: The number of laser treatments for ROP carried out by this unit has increased steadily between 2009 and 2015 and this may in part be due to the increased need for ROP treatment in extremely preterm babies, whose survival has increased in the same period. These data may aid planning for ROP services.
PMID: 30651593 [PubMed - as supplied by publisher]
Clinical-grade stem cell-derived retinal pigment epithelium patch rescues retinal degeneration in rodents and pigs.
Sci Transl Med. 2019 Jan 16;11(475):
Authors: Sharma R, Khristov V, Rising A, Jha BS, Dejene R, Hotaling N, Li Y, Stoddard J, Stankewicz C, Wan Q, Zhang C, Campos MM, Miyagishima KJ, McGaughey D, Villasmil R, Mattapallil M, Stanzel B, Qian H, Wong W, Chase L, Charles S, McGill T, Miller S, Maminishkis A, Amaral J, Bharti K
Considerable progress has been made in testing stem cell-derived retinal pigment epithelium (RPE) as a potential therapy for age-related macular degeneration (AMD). However, the recent reports of oncogenic mutations in induced pluripotent stem cells (iPSCs) underlie the need for robust manufacturing and functional validation of clinical-grade iPSC-derived RPE before transplantation. Here, we developed oncogenic mutation-free clinical-grade iPSCs from three AMD patients and differentiated them into clinical-grade iPSC-RPE patches on biodegradable scaffolds. Functional validation of clinical-grade iPSC-RPE patches revealed specific features that distinguished transplantable from nontransplantable patches. Compared to RPE cells in suspension, our biodegradable scaffold approach improved integration and functionality of RPE patches in rats and in a porcine laser-induced RPE injury model that mimics AMD-like eye conditions. Our results suggest that the in vitro and in vivo preclinical functional validation of iPSC-RPE patches developed here might ultimately be useful for evaluation and optimization of autologous iPSC-based therapies.
PMID: 30651323 [PubMed - in process]
Is the combined auriculotherapy approach superior to magneto-auriculotherapy alone in aging males with lower urinary tract symptoms? A randomized controlled trial.
Aging Male. 2019 Jan 16;:1-12
Authors: Suen LKP, Yeh CH, Yeung SKW, Yeung JWF
OBJECTIVES: The negative impact of lower urinary tract symptoms (LUTS) on affected males is substantial. This study aims to assess whether a combined auriculotherapy (AT) using laser AT (LAT) and magneto-AT (MAT) is more effective than using MAT alone or placebo for managing LUTS of aging males.
METHODS: A randomized controlled, double-blinded trial was conducted. Sixty-two aging males with moderate or severe LUTS symptoms were randomly allocated into groups: Group 1, placebo LAT plus placebo MAT (n = 20); Group 2, combined AT approach using LAT plus MAT (n = 20); and Group 3, placebo LAT followed by MAT (n = 22). Six ear acupoints assumed to be suitable for alleviating LUTS were used. The total treatment period was 4 weeks, with follow-up visits till 3 months. Generalized estimating equations model was used for the examination of the interactions among the groups over time.
RESULTS: A combined AT approach exhibited a stronger treatment effect in relieving voiding problems, improving the peak urinary flow rate, and reducing the post-void residual urine than the placebo group or MAT alone.
CONCLUSIONS: This study demonstrates that the AT protocol used in this study for aging males with LUTS is feasible and can be adopted in future study of increased scale.
PMID: 30651007 [PubMed - as supplied by publisher]
Intramedullary and Extramedullary Thoracic Spinal Lipomas Without Spinal Dysraphism: Clinical Presentation and Surgical Management.
World Neurosurg. 2019 Jan;121:156-159
Authors: Chen KY, Osorio J, Rivera J, Chou D
BACKGROUND: Intradural intramedullary lipomas without dysraphism are rare tumors. Although they appear extramedullary on imaging, they invade into the intramedullary substance of the spinal cord. We present 2 cases and discuss their clinical presentation, radiologic findings, and surgical management.
CASE DESCRIPTION: Case 1 is a 21-year-old woman who presented with upper back pain from recurrent lipoma. She had undergone partial excision in 2008 at an outside hospital. Physical examination revealed full strength but hyperreflexia in the legs. Magnetic resonance imaging (MRI) revealed a recurrent thoracic spinal tumor with spinal cord compression. Surgery was performed, and it was found that the tumor was both extramedullary and intramedullary, with an obscure delineation between tumor and cord. Subtotal excision was performed, and the patient remained neurologically intact. Case 2 is a 47-year-old woman who presented with leg weakness, difficulty in walking, and foot drop. Physical examination revealed 4/5 in the lower extremities. MRI demonstrated a spinal lipoma with thoracic cord compression. Even though the tumor appeared to be an extramedullary lesion by MRI, intraoperatively, the tumor became intramedullary with loss of distinction between the spinal cord and tumor. Subtotal excision was performed, and the patient regained her strength to 5/5 postoperatively.
CONCLUSIONS: Intramedullary thoracic spinal lipomas without spinal dysraphism are rare. Although these tumors may appear completely extramedullary on imaging, extreme care should be taken during surgery because the lesions eventually become intramedullary, intercalating within the substance of the spinal cord, precluding gross total resection.
PMID: 30315981 [PubMed - indexed for MEDLINE]
Managing normal tension glaucoma by lowering the intraocular pressure.
Surv Ophthalmol. 2019 Jan - Feb;64(1):111-116
Authors: Razeghinejad MR, Lee D
PMID: 30300624 [PubMed - indexed for MEDLINE]
Motorized 0.8-mm micropunch grafting for refractory vitiligo: A retrospective study of 230 cases.
J Am Acad Dermatol. 2018 Oct;79(4):720-727.e1
Authors: Bae JM, Lee JH, Kwon HS, Kim J, Kim DS
BACKGROUND: Punch grafting for vitiligo is time-consuming and can result in cobblestone-like appearances. We devised a motorized 0.8-mm micropunch grafting procedure to overcome these limitations.
OBJECTIVE: To assess the therapeutic effectiveness and adverse events associated with micropunch grafting in refractory vitiligo.
METHODS: We retrospectively reviewed 230 cases in 208 patients with stable vitiligo who underwent motorized 0.8-mm micropunch grafting during January 2015-August 2017. Treatment success was defined as ≥75% repigmentation, and factors associated with the outcome were assessed.
RESULTS: Overall, 181 of 230 lesions (78.7%) achieved treatment success after a median of 6 months with postoperative excimer therapy. Lesions on the face and neck, and disease stability of ≥12 months were good prognostic factors for treatment success. Common adverse events were color mismatch (24.8%) and cobblestone appearance (18.3%). Overall, the treatment was tolerable.
LIMITATIONS: This was a retrospective study.
CONCLUSION: Micropunch grafting using a motorized 0.8-mm punch can successfully treat refractory vitiligo with short procedure times and excellent outcomes. This technique could be a rapid and convenient surgical option with acceptable adverse events and is promising for treating refractory vitiligo on an outpatient basis, particularly in patients who are unlikely to tolerate prolonged surgery.
PMID: 29913258 [PubMed - indexed for MEDLINE]
Surgical smoke: Risk assessment and mitigation strategies.
J Am Acad Dermatol. 2018 Oct;79(4):746-755
Authors: Georgesen C, Lipner SR
BACKGROUND: Although many dermatologic surgeons are aware of the risks of surgical smoke, many do not use hazard reduction strategies.
OBJECTIVE: To identify the infectious, inhalational, chemical, and mutagenic risks of surgical smoke in dermatologic procedures and suggest evidence-based hazard reduction strategies.
METHODS: A review of articles indexed for MEDLINE on PubMed using the keywords surgical smoke, dermatology, surgical mask, respirator, smoke evacuator, and guidelines in 13 combinations was performed by using Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols. The review included data from 45 articles from the dermatology, surgery, infectious disease, obstetrics, and cancer biology literature.
RESULTS: There are risks associated with surgical smoke, and although some dermatologists are aware of these risks, many are not using hazard reduction strategies such as smoke evacuators and surgical masks.
LIMITATIONS: Most of the data regarding the hazards of surgical smoke and methods for smoke safety are derived from in vitro and in vivo studies in nonhumans, as well as from resources outside of the dermatology literature.
CONCLUSION: Standardized guidelines for surgical smoke safety should be implemented in the dermatology community and residency curriculum.
PMID: 29902546 [PubMed - indexed for MEDLINE]
The Dentoalveolar Prosthesis: A Novel Approach in the Reconstruction of Hard and Soft Tissue Deficiencies.
J Prosthodont. 2018 Jul;27(6):544-549
Authors: Doll JK, Barndt P, Grant G
A clinical problem commonly encountered by the advanced restorative dentist is a requirement to replace missing teeth and the supporting alveolus in areas adjacent to healthy or manageable dentition. A potential solution could utilize a dentoalveolar prosthesis fabricated on two or more implants in the edentulous area. The implant substructure, or framework, may be cast, milled, or selectively laser melted from a variety of metals. A superstructure, or ceramic overlay incorporating a ceramic or composite resin gingival tissue component, is constructed to fit over the implant substructure and luted to the substructure with resin cement. This implant-supported fixed dental prosthesis identifies a solution for the replacement of both teeth and supporting alveolar bone. It restores comfort, function, and esthetics to the patient.
PMID: 28513894 [PubMed - indexed for MEDLINE]