Lasers in Medical Science最新文献

Onychomycosis is a persistent nail infection often caused by dermatophytes or yeasts, with conventional treatments limited by long durations, poor compliance, and resistance. The long-pulsed Nd: YAG 1064 nm laser (NDYL) has emerged as a potential adjunct; however, its effects in combination with antifungals against yeast-related cases are unclear. This study examined the in vitro synergistic effect of NDYL with four antifungal agents-Ketoconazole (KET), Itraconazole (ITK), Voriconazole (VRC), and Terbinafine(TRB)-on clinical yeasts isolates from patients with onychomycosis. Yeast isolates were identified through ITS PCR sequencing. Susceptibility testing was conducted using the CLSI disk diffusion method (document M44-A2). Two experimental series-vital nail scrapings and cultured colonies-were exposed to standardized NDYL laser parameters. Antifungal activity was assessed by measuring inhibition zone diameters, and statistical comparisons were performed using paired t-tests. NDYL significantly enhanced antifungal activity, with the most pronounced effects observed for KET and ITC (p < 0.05). KET achieved up to 100% sensitivity improvement in nail scraping samples. VRC and TRB demonstrated moderate but consistent enhancements. Recorded irradiation temperatures remained below 42 °C, suggesting primarily non-thermal mechanisms. The relative frequencies of increased inhibition zone diameters in nail scrapings, yeast colonies, and combined datasets were: ITC (83.3%, 50.0%, 66.7%), VRC (66.7%, 50.0%, 58.3%), TRB (33.3%, 16.7%, 25.0%), and KET (100%, 66.7%, 83.3%). These findings support NDYL as a potential adjunctive tool for enhancing antifungal efficacy in yeast-associated onychomycosis. Further in vivo research is warranted to confirm clinical applicability and refine treatment protocols.

Objective: This in vitro study compared the efficacy of Er, Cr: YSGG laser (2780 nm), diode laser (976 nm), passive ultrasonic irrigation (PUI), and conventional syringe-needle (CSN) irrigation in smear layer removal, evaluating irrigant chemistry and root canal level.

Methods: 160 single-rooted premolars were instrumented and divided into four irrigation groups (n = 40/group): Er, Cr: YSGG (25 mJ, 50 Hz, radial-firing tip), diode laser (Pulsed 50%, 1.5 W), PUI, and CSN (side-vented needle). Groups were subdivided by irrigant (NaOCl + EDTA, EDTA, NaOCl, saline; n = 10/subgroup). Activation involved four 15-second cycles. Smear layer was scored (1-5) via SEM by blinded evaluators. Data were analyzed with Kruskal-Wallis and Mann-Whitney tests (p ≤ 0.05).

Results: Er, Cr: YSGG achieved the lowest scores (best cleaning) across all thirds, outperforming diode laser, PUI, and CSN. NaOCl + EDTA was the most effective irrigant (p < 0.05). Remarkably, saline with Er, Cr: YSGG surpassed NaOCl alone. Apical thirds showed consistently poorer removal.

Conclusion: Er, Cr: YSGG laser activation with NaOCl + EDTA is the most effective protocol for smear layer removal. The powerful mechanical effects of Er, Cr: YSGG dominated when using saline. Diode laser activation also surpassed PUI.

Background and aims: Primary localized cutaneous amyloidosis (PLCA) is a persistent dermatological disorder characterized by the accumulation of amyloid deposits within the dermal papillae, resulting in pigmentation alterations, pruritus, and textural modifications of the skin. Given the lack of a standardized treatment for this condition, this review aims to evaluate the efficacy and safety of various procedural modalities for PLCA management.

Methods: PubMed/Medline, Scopus, and Web of Science were systematically searched until August 25th, 2024. The study selection was restricted to English-language clinical studies, excluding case reports and case series. Our study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews and meta-analyses.

Results: Based on our inclusion criteria, 16 studies with 432 patients were included, assessing fractional CO₂ laser, Nd: YAG laser, Er: YAG laser, microneedling, and phototherapy for PLCA treatment. Fractional CO₂ laser effectively improved pigmentation and pruritus, especially when combined with corticosteroids or vitamin C. Nd: YAG and Er: YAG lasers demonstrated favorable outcomes, with combination therapies enhancing efficacy. Microneedling and phototherapy (PUVA/UVB) also showed benefits, with PUVA being superior for pruritus.

Conclusion: Fractional CO₂ laser, especially with corticosteroids or vitamin C, showed the most effective results for pigmentation, pruritus, and amyloid reduction in PLCA. Nd: YAG and Erbium lasers, microneedling, and phototherapy also demonstrated benefits. However, further comparative clinical trials are needed to determine the most effective approach and establish standardized treatment protocols.

Frozen shoulder (adhesive capsulitis) is a debilitating condition characterized by progressive shoulder pain and restricted range of motion. Photobiomodulation (PBM) therapy, using a 650 nm diode laser, has emerged as a promising non-invasive treatment modality. To investigate the physiological mechanisms and therapeutic efficacy of 650 nm diode laser photobiomodulation in treating frozen shoulder. A comprehensive review of the current literature on PBM mechanisms, cellular responses, and clinical applications in the treatment of frozen shoulder was conducted. Focus was placed on 650 nm wavelength therapeutic protocols and outcomes. PBM at 650 nm wavelength demonstrates significant therapeutic effects through mitochondrial cytochrome c oxidase activation, leading to increased ATP production, reduced inflammatory mediators, enhanced collagen synthesis, and improved tissue repair mechanisms. Clinical studies have shown significant pain reduction, improved range of motion, and accelerated functional recovery in patients with frozen shoulder. 650 nm diode laser PBM therapy represents an effective, non-invasive treatment option for frozen shoulder through well-established cellular and molecular mechanisms that promote tissue healing and pain resolution.

Background: Laser acupuncture (LA) is an emerging therapeutic modality that employs non-invasive laser irradiation to induce biological effects and enhance physiological functions. Its application in clinical settings has become widespread, with extensive research supporting its efficacy in rehabilitation and various medical treatments.

Objective: This study utilized CiteSpace to perform a visual analysis of 957 LA-related publications (1996-2024), aiming to identify evolving research trends, track the progression of LA in medical fields, and offer insights for future investigations.

Methods: Literature on LA from the Web of Science (WOS) Core Collection (1996-2024) was analyzed using CiteSpace. Visualization maps were generated for keywords, authors, institutions, and journals. Co-occurrence, clustering, and burst detection analyses were conducted on author networks, national collaborations, and keyword trends.

Results and conclusion: A total of 957 studies were analyzed. Key findings include: (1) LA demonstrates significant interdisciplinary potential, meriting further exploration. (2) Future research should extend beyond efficacy assessments and systematic reviews to explore innovative perspectives and broaden research directions.

This paper aimed to verify how a new protocol, recently proposed for treating chronic wounds due to its excellent antimicrobial properties, affects human dermal fibroblasts (NHDFs). Single and combined action of light-emitting diodes (LED), complex magnetic fields (CMFs), and methylglyoxal (MGO) on cell viability and activity of NHDFs were investigated. Our first objective was to exclude any toxicity of this combined treatment on these cells. NHDFs were exposed to LED light for 17 min, CMFs for 22 min, MGO, MGO + LED, and MGO + CMFs, and then were assessed for cell viability, morphology, cytoskeletal integrity, collagen type I production, and migration capacity. Results of combined treatments were compared with those of single treatments and unexposed controls. NHDFs exposed to both single and combined treatments maintained viability, morphology, and cytoskeletal integrity, showing no signs of cytotoxicity. MGO at low concentrations was non-toxic and, when combined with other technologies, could confer beneficial effects on cell adhesion. LED stimulated collagen type I synthesis, and the production increased in samples subjected to the combined action of MGO + LED. CMFs notably accelerated fibroblasts' migration in scratch assays, and when combined with MGO, they further enhanced this effect. The effects of MGO + LED and MGO + CMFs were probably due to cellular uptake and receptor sensitivity. The tested protocols were not only non-toxic but also promoted beneficial effects on the vitality and activity of dermal fibroblasts, confirming their potential in treating chronic wounds.

Laser radiation involving the mid-infrared range of a 1470 nm wavelength (the "water", or W-laser) coincides with the absorption peak in water and is recognized as one the most effective methods for performing endovenous laser ablation (EVLA) of varicose veins in patients with chronic venous disease (CVD). The mechanism of action on the vein of laser radiation with a 1470 nm wavelength ensures direct action on all layers of the vein wall and thermal damage. This study was brought up to evaluate the effects of low-energy EVLA with the use of a 1470-nm laser with the average linear endovenous energy density (LEED) of 80 J/cm, on the key serum biomarkers of vascular inflammation and remodeling. We have additionally assessed patients' quality-of-life (QoL). To study the effects of low-energy EVLA with the use of a 1470-nm laser on vascular inflammation and remodeling parameters in patients with CVD. In this prospective cohort study subjects with symptomatic varicose veins, clinical class C2-C3 according to the CEAP classification (N = 95) were allocated non-randomly to four groups: group 1 - control (compression stockings only); group 2 - comparison (conservative treatment with micronized purified flavonoid fraction, MPFF); group 3 - EVLA with the use of a 1470-nm laser with the average LEED of 80 J/cm; group 4 - EVLA with a 1470-nm laser with the average LEED of 80 J/cm with adjuvant MPFF therapy. Serum levels of E-selectin, MCP-1, VEGF, MMP-2 were measured. Additionally, QoL analysis was performed using a CIVIQ-20 questionnaire. Treatments were associated with significant reductions in inflammatory biomarkers including E-selectin, MCP-1, and VEGF for MPFF (p < 0.001), and E-selectin, MCP-1 and MMP-2 for EVLA (p < 0.001). EVLA with the use of a 1470-nm laser with the average LEED of 80 J/cm with adjuvant MPFF therapy was associated with most notable reductions in all studied biomarkers (p < 0.001). CIVIQ-20 was improved by 23%, 29%, 36% and 40% at 2 months in groups 1, 2, 3, and 4, respectively. Performing endovenous laser ablation with the use of a 1470-nm laser with the average LEED of 80 J/cm in patients with chronic venous disease is associated with a statistically significant reduction in serum biomarkers of vascular inflammation and remodelling such as E-selectin, MCP-1, VEGF, MMP-2, as well as improvement in quality of life. Adjuvant therapy with MPFF on top of EVLA gives best results in terms of improved biochemistry and QoL.

Background: It is challenging to find effective breast cancer treatments as this disease is highly varied. But photobiomodulation therapy (PBMT) has shown promising results, specifically with the usage of yellow light. Even so, much work is still needed to understand its effect in cancer treatment.

Objective: The aim is to determine the effect of 589 nm yellow laser light (5-20 J/cm²) at various dosages on cellular activities like metabolism, cell death (apoptosis), and reactive oxygen species (ROS) production, focusing on MCF-7 (ER-positive) and MDA-MB-231 (triple-negative) human breast cancer cells. This is expected to explain the drivers of photobiomodulation.

Methods: The MDA-MB-231 and MCF-7 breast cancer cells are exposed continuously to yellow light at 5, 10, 20 J/cm². After being exposed for 24 and 48 h, the cells' metabolic activity was measured using MTT assay. Apoptosis was measured using Annexin V-FITC/PI staining. ROS levels were measured using DCFH-DA assays.

Results: The dosage-based yellow light exposure substantially decreased metabolic activity and boosted cell death (apoptosis) in both breast cancer cells, more so in the MCF-7 cells than the MDA-MB-231 cells. After exposure, the ROS levels particularly for the MCF-7 cells rose substantially, suggesting the major role of oxidative stress.

Conclusion: Yellow laser exposure triggers targeted cell death and cytotoxic effects in breast cancer cells, especially in ER-positive MCF-7 cells. The findings suggest that yellow laser PBMT is promising as a treatment approach for certain breast cancers.

The 1927 nm Thulium laser has emerged as a promising tool for the treatment of dermatological conditions. This systematic review aimed to analyze the efficacy and applicability of this technology. A total of 17 studies were included, involving 448 participants with various dermatological disorders. The results indicated that the 1927 nm laser promoted improvements in skin texture, pigmentation reduction, and scar appearance, with an acceptable of safety profile. On average, treatment protocols included three sessions at monthly intervals and a follow-up of 120 days. Adverse events were mild and transient, although relapses were observed in cases of melasma. There was considerable variability in treatment parameters across studies, and most of them presented a moderate to high risk of bias. Therefore, future research is needed to standardize clinical protocols and confirm long-term effects. Nevertheless, the 1927 nm laser stands out as a valuable dermatological therapeutic resource with the potential to enhance clinical outcomes.

Purpose: Female pattern hair loss (FPHL) is a major concern for women experiencing hair thinning. While minoxidil 5% (MIN) is a medically approved treatment and photobiomodulation therapy (PBMt) has shown effectiveness in stimulating hair growth, treatments typically last 24 weeks. This study aimed to evaluate the effects of combining PBMt with topical MIN for treating FPHL within a shorter 12.5-week timeframe, focusing on hair growth phases.

Methods: Nine women aged 30 to 50 years with FPHL participated. They applied MIN twice daily to the scalp throughout the treatment period. In the clinic, hair was sectioned, and one side of the scalp was randomly assigned to receive 25 sessions of red laser (100 mW, 4 J/point), delivered at 15 evenly spaced points. Treatments were administered twice a week, while the opposite side received sham irradiation. Standardized photographs, a quality of life (QoL) questionnaire, and phototrichograms were used to evaluate the outcomes.

Results: Both the MIN and PBMt + MIN groups showed significant improvements in QoL scores and hair density. Additionally, both groups experienced increased hair density and a higher percentage of hairs in the anagen phase. Remarkably, the PBMt + MIN group exhibited a significantly greater reduction in telogen-phase hairs.

Conclusion: These findings suggest that PBMt may enhance MIN therapy for FPHL, particularly in reducing telogen-phase hair counts within a shorter treatment period.

Clinical trial number: Not applicable.