Low-level laser therapy in the management of plantar fasciitis: a randomized controlled trial

This study aimed at estimating the extent to which a combination therapy of low-level laser therapy (LLLT) with exercise and orthotic support (usual care) affects functional ability in the patient with plantar fasciitis (PF) when compared to usual care alone. Participants with PF were randomly allocated into two groups: LLLT (n?=?27) and control (n?=?22). All the participants received home exercise program with orthotic support. In addition, the LLLT group received a gallium-aluminum-arsenide laser with a 850-nm wavelength for ten sessions, three times a week. Functional outcomes were measured by function subscale of American Orthopedic Foot and Ankle Society Score (AOFAS-F) and 12-min walking test including walking speed, cadence, and activity-related pain using visual analog scale (VAS).The scores were recorded at baseline, third week, and third month after the treatment. Analysis was performed using repeated measures ANOVA and an intention to treat approach using multiple imputations. There was a significant improvement in AOFAS-F total score at 3 weeks in both groups (LLLT, p?<?0.001; control, p?=?0.002), but the improvements were seen only for the LLLT group for AOFAS-F total score (p?=?0.04) and two individual items of AOFAS-F (walking distance (p?<?0.001) and walking surface (p?=?0.01)) at 3 months. The groups were comparable with each other for both walking speed and cadence at all assessment times (p?>?0.05). Both groups showed significant reduction in pain over 3 months (LLLT, p?<?0.001; control, p?=?0.01); however, the LLLT group had lower pain than the control group at 3 months (p?=?0.03). The combination therapy of LLLT with usual care is more effective to improve functional outcomes and activity-related pain when compared to usual care alone.     

Low-level laser therapy stimulates tissue repair and reduces the extracellular matrix degradation in rats with induced arthritis in the temporomandibular joint

The objective of this study was to characterize morphological and biochemistry action of low-level laser therapy (LLLT) on induced arthritis in the temporomandibular joint (TMJ) of rats. Twenty-four male Wistar rats were randomly divided into groups with 12 animals each: (AG) group with arthritis induced in the left TMJ and (LG) group with arthritis induced in the left TMJ and treated with LLLT (830 nm, 30 mW, 3 J/cm²). Right TMJs in the AG group were used as noninjected control group (CG). Arthritis was induced by intra-articular injection of 50 μl Complete Freund’s Adjuvant (CFA) and LLLT began 1 week after arthritis induction. Histopathological analysis was performed using sections stained with hematoxylin-eosin, Toluidine Blue, and picrosirius. Biochemical analysis was determined by the total concentration of sulfated glycosaminoglycans (GAGs) and evaluation of matrix metalloproteinases (MMP-2 and MMP-9). Statistical analysis was performed using paired and unpaired t tests, with p?<?0.05. Compared to AG, LG had minor histopathological changes in the TMJ, smaller thickness of the articular disc in the anterior (p?<?0.0001), middle (p?<?0.0001) and posterior regions (p?<?0.0001), high birefringence of collagen fibers in the anterior (p?<?0.0001), middle (p?<?0.0001) and posterior regions (p?<?0.0001) on the articular disc, and statistically lower activity of MMP-2 latent (p?<?0.0001), MMP-2 active (P?=?0.02), MMP-9 latent (p?<?0.0001), and MMP-9 active (p?<?0.0001). These results suggest that LLLT can increase the remodeling and enhancing tissue repair in TMJ with induced arthritis.     

Muscle fiber conduction velocity and EMG amplitude of the upper trapezius muscle in healthy subjects after low-level laser irradiation: a randomized,double-blind,placebo-controlled,crossover study

Although low-level laser therapy (LLLT) is an important resource for the treatment of non-specific neck pain patients, the dose which presents the greatest therapeutic potential for the treatment of this pathology is still unclear. The present study aimed to evaluate the immediate effect of LLLT on the muscle fiber conduction velocity (MFCV) and electromyographic activity (EMG) of the upper trapezius (UT) muscle in healthy individuals. A total of 20 healthy subjects were enrolled in a randomized, double-blind, crossover study. Active LLLT (820 nm wavelength, 30 mW, energy total 18 J) or placebo LLLT (pLLLT) was delivered on the UT muscle. Each subject was subjected to a single session of active LLLT and pLLLT. Surface electromyography (sEMG) signal of the UT muscle was recorded during five different step contractions of shoulder elevation force (10–30% maximal voluntary contraction) pre- and post-LLLT irradiation. The values of MFCV and sEMG global amplitude (RMS_G) were used to calculate the effects of LLLT. The results showed no difference in the MFCV comparing the LLLT and pLLLT groups (F?=?0.72 p?=?0.39, η _p ²?=?0.004). However, a significant difference was observed in the RMS_G between the LLLT and pLLLT (F _1,2?=?16.66; P?<?0.0001, η _p ²?=?0.09). Individuals who received active LLLT presented a significant decrease in RMS_G after laser application (F?=?61.28; p?<?0.0001, η _p ²?=?0.43). In conclusion, the 820 nm LLLT, with energy total of 18 J, did not alter the MFCV but significantly reduced the sEMG signal amplitude of the upper trapezius muscle in healthy subjects to a level of up to 30% of maximal voluntary contraction.     

Effect of photobiomodulation on connective tissue remodeling and regeneration of skeletal muscle in elderly rats

The purpose of this study was to evaluate the effects of low-level laser therapy (LLLT) on morphological aspects, IL-6 and IL-1β expressions, as well as the distribution and organization of collagen in the tibialis anterior (TA) muscle of elderly rats submitted to cryoinjury. Histological photomicrographs were taken of TA muscles stained with HE and picrosirius red. Immunohistochemistry was used for the evaluation of IL-6 and IL-1β. Male Wistar rats, aged 20 months, were distributed into three groups: (1) control animals not injured or treated with LLLT (n?=?5), (2) cryoinjury without LLLT treatment (n?=?15), and (3) cryoinjury treated with infrared LLLT (n?=?15). LLLT was applied to the TA 2 h after of the injury induction and consisted of daily applications until the sacrifice (1, 3, and 7 days). The following parameters were used: λ?=?780 nm, power density 1 W/cm², output power 40 mW, 10 s per point, 8 points, and 3.2 J of total energy. In the histomorphological analysis, the treated group exhibited a significant decrease in inflammatory infiltrate (p?<?0.001) as well as an increase immature fibers and new blood vessels at 7 days compared to the untreated group (p?<?0.05). Furthermore, treatment induced a better collagen distribution and organization at 7 days in comparison to the untreated group (p?<?0.05). In conclusion, LLLT demonstrated a modulatory effect on the muscle repair process in elderly animals with regard to the collagen remodeling and morphological aspects of muscle tissue.     

Effects of oral motor exercises and laser therapy on chronic temporomandibular disorders: a randomized study with follow-up

This study investigated the efficacy of combining low-level laser therapy (LLLT) with oral motor exercises (OM-exercises) for rehabilitation of patients with chronic temporomandibular disorders (TMDs). Eighty-two patients with chronic TMD and 20 healthy subjects (control group) participated in the study. Patients were randomly assigned to treatment groups: GI (LLLT?+?OM exercises), GII (orofacial myofunctional therapy—OMT—which contains pain relief strategies and OM-exercises), and GIII (LLLT placebo?+?OM-exercises) and GIV (LLLT). LLLT (AsGaAl; 780-nm wavelength; average power of 60 mW, 40 s, and 60?±?1.0 J/cm²) was used to promote analgesia, while OM-exercises were used to reestablish the orofacial functions. Evaluations at baseline (T1), after treatment immediate (T2), and at follow-up (T3) were muscle and joint tenderness to palpation, TMD severity, and orofacial myofunctional status. There was a significant improvement in outcome measures in all treated groups with stability at follow-up (Friedman test, P?<?0.05), but GIV did not show difference in orofacial functions after LLLT (P?>?0.05). Intergroup comparisons showed that all treated groups had no difference in tenderness to palpation of temporal muscle compared to GC at follow-up (Kruskal-Wallis test, P?<?0.01). Moreover, GI, GII, and GIII showed no difference from GC in orofacial functional condition (T2 and T3) while they differed significantly from GIV (P?<?0.01). In conclusion, LLLT combined with OM-exercises was more effective in promoting TMD rehabilitation than LLLT alone was. Similar treatment results were verified with the OMT protocol.     

Radiological and biochemical effects (CTX-II,MMP-3, 8, and 13) of low-level laser therapy (LLLT) in chronic osteoarthritis in Al-Kharj,Saudi Arabia

Inflammation of synovial membrane and degeneration of articular cartilage in osteoarthritis (OA) lead to major changes in joint space width (JSW) and biochemical components such as collagen-II telopeptide (CTX-II) and matrix metallo protineases (MMP-3, 8, and 13). Low-level laser therapy (LLLT) is thought to have an analgesic effect as well as biomodulatory effect on microcirculation and cartilage regeneration in animal studies. The objective of this study was to examine the analgesic and biochemical effect of LLLT in patients with knee osteoarthritis. Subjects (n?=?34) who fulfilled the selection criteria were randomly divided into active group (n?=?17) and placebo group. Subjects in active group were irradiated laser with the frequency of 3 days per week for 4 weeks with the specific parameters on 8 different points on the joint at 1.5 J per point for 60 s for 8 points for a total dose of 12 J in a skin contact method. The placebo group was treated with the same probe with minimum emission of energy. Visual analog scale for pain intensity, joint space width, collagen-II telopeptide, and matrix metallo protinease-3, 8, and 13 was measured before treatment and at 4 and 8 weeks following treatment. Data are analyzed with mean values and standard deviation with p?<?0.05. Baseline values of all outcome measures show insignificant difference (p?>?0.05) in both groups which shows homogeneity. After 4- and 8-week treatment, active laser group shows more significant difference (p?<?0.001) in all the parameters than the placebo laser group (p?>?0.05). Our results show that low-level laser therapy was more efficient in reducing pain and improving cartilage thickness through biochemical changes.     

Acute effects of low-level laser therapy irradiation on blood lactate and muscle fatigue perception in hospitalized patients with heart failure—a pilot study

The objective of the present study is to evaluate the acute effects of low-level laser therapy (LLLT) on functional capacity, perceived exertion, and blood lactate in hospitalized patients with heart failure (HF). Patients diagnosed with systolic HF (left ventricular ejection fraction <45 %) were randomized and allocated prospectively into two groups: placebo LLLT group (n?=?10)—subjects who were submitted to placebo laser and active LLLT group (n?=?10)—subjects who were submitted to active laser. The 6-min walk test (6MWT) was performed, and blood lactate was determined at rest (before LLLT application and 6MWT), immediately after the exercise test (time 0) and recovery (3, 6, and 30 min). A multi-diode LLLT cluster probe (DMC, São Carlos, Brazil) was used. Both groups increased 6MWT distance after active or placebo LLLT application compared to baseline values (p?=?0.03 and p?=?0.01, respectively); however, no difference was observed during intergroup comparison. The active LLLT group showed a significant reduction in the perceived exertion Borg (PEB) scale compared to the placebo LLLT group (p?=?0.006). In addition, the group that received active LLLT showed no statistically significant difference for the blood lactate level through the times analyzed. The placebo LLLT group demonstrated a significant increase in blood lactate between the rest and recovery phase (p?<?0.05). Acute effects of LLLT irradiation on skeletal musculature were not able to improve the functional capacity of hospitalized patients with HF, although it may favorably modulate blood lactate metabolism and reduce perceived muscle fatigue.     

Effect of low-level laser therapy on tooth sensitivity induced by in-office bleaching

This study aimed to investigate the effect of low-level laser therapy (LLLT) on tooth sensitivity induced by in-office bleaching. Sixty-six patients enrolled in this randomized clinical trial. Following the in-office procedure with 40 % hydrogen peroxide, the participants were randomly divided into three groups. The patients in group 1 received irradiation from a low-level red laser (LLRL; 660 nm, 200 mW, 15 s, 12 J/cm²), whereas participants in group 2 were subjected to a low-level infrared laser (LLIL; 810 nm) under similar conditions as in group 1. In group 3 (placebo), the laser treatment was the same as that in groups 1 and 2, but without energy output. The degree of tooth sensitivity was recorded at 1, 24, and 48 h after bleaching using a visual analog scale (VAS). The change in tooth shade was measured 30 days after tooth whitening. The intensity of tooth sensitivity was not significantly different between groups at 1 h after bleaching (p?>?0.05). At 24 h after therapy, pain level was significantly lower in the LLIL group compared to the LLRL and placebo groups (p?<?0.05). At 48 h after bleaching, VAS scores in the LLIL and LLRL groups were comparable to each other (p?>?0.05) and both were significantly lower than that of the placebo group (p?<?0.05). There was no significant difference in the efficacy of tooth whitening among groups (p?>?0.05). LLLT with an infrared diode laser could be recommended as a suitable strategy to reduce the intensity of tooth sensitivity after in-office bleaching.     

Low-level laser therapy with 940 nm diode laser on stability of dental implants: a randomized controlled clinical trial

Low-level laser therapy (LLLT) is a non-invasive modality to promote osteoblastic activity and tissue healing. The aim of this study was to evaluate the efficacy of LLLT for improvement of dental implant stability. This randomized controlled clinical trial was performed on 80 dental implants placed in 19 patients. Implants were randomly divided into two groups (n = 40). Seven sessions of LLLT (940 nm diode laser) were scheduled for the test group implants during 2 weeks. Laser was irradiated to the buccal and palatal sides. The same procedure was performed for the control group implants with laser hand piece in “off” mode. Implant stability was measured by Osstell Mentor device in implant stability quotient (ISQ) value immediately after surgery and 10 days and 3, 6, and 12 weeks later. Repeated measures ANOVA was used to compare the mean ISQ values (implant stability) in the test and control groups. Statistical test revealed no significant difference in the mean values of implant stability between the test and control groups over time (P = 0.557). Although the mean values of implant stability changed significantly in both groups over time (P < 0.05). Although the trend of reduction in stability was slower in the laser group in the first weeks and increased from the 6th to 12th week, LLLT had no significant effect on dental implant stability.     

Photobiomodulation therapy protects skeletal muscle and improves muscular function of mdx mice in a dose-dependent manner through modulation of dystrophin

This study aimed to analyze the protective effects of photobiomodulation therapy (PBMT) with combination of low-level laser therapy (LLLT) and light emitting diode therapy (LEDT) on skeletal muscle tissue to delay dystrophy progression in mdx mice (DMD ^mdx ). To this aim, mice were randomly divided into five different experimental groups: wild type (WT), placebo-control (DMD ^mdx ), PBMT with doses of 1 J (DMD ^mdx ), 3 J (DMD ^mdx ), and 10 J (DMD ^mdx ). PBMT was performed employing a cluster probe with 9 diodes (1 x 905nm super-pulsed laser diode; 4 x 875nm infrared LEDs; and 4 x 640nm red LEDs, manufactured by Multi Radiance Medical®, Solon - OH, USA), 3 times a week for 14 weeks. PBMT was applied on a single point (tibialis anterior muscle—bilaterally). We analyzed functional performance, muscle morphology, and gene and protein expression of dystrophin. PBMT with a 10 J dose significantly improved (p?<?0.001) functional performance compared to all other experimental groups. Muscle morphology was improved by all PBMT doses, with better outcomes with the 3 and 10 J doses. Gene expression of dystrophin was significantly increased with 3 J (p?<?0.01) and 10 J (p?<?0.01) doses when compared to placebo-control group. Regarding protein expression of dystrophin, 3 J (p?<?0.001) and 10 J (p?<?0.05) doses also significantly showed increase compared to placebo-control group. We conclude that PBMT can mainly preserve muscle morphology and improve muscular function of mdx mice through modulation of gene and protein expression of dystrophin. Furthermore, since PBMT is a non-pharmacological treatment which does not present side effects and is easy to handle, it can be seen as a promising tool for treating Duchenne’s muscular dystrophy.     

Low-level laser therapy combined to functional exercise on treatment of fibromyalgia: a double-blind randomized clinical trial

This study aims to investigate the effects of low-level laser therapy (LLLT) combined to a functional exercise program on treatment of FM. A double-blind and placebo-controlled randomized clinical trial composed of 22 women divided into two groups: placebo group (functional exercise program associated with placebo phototherapy n?=?11) and laser group (same exercise program associated with active phototherapy; n?=?11). Each session lasted from 40 to 60 min and was performed three times a week for 8 weeks. Phototherapy (808 nm, 100 mW, 4 J, and 142.85 J/cm² per point) was bilaterally applied to different points of the quadriceps (8), hamstrings (6), and triceps sural muscles (3) immediately after each exercise session. Pre- and post-intervention evaluations regarding pain (sites, intensity, and threshold), functional performance (balance, functional tests), muscle performance (flexibility and isokinetic variables), depression, and quality of life were conducted. A reduction in pain and improvement in functional and muscular performance, depression, and quality of life were observed in both groups (p?<?0.05); however, with no significant differences between them (p?>?0.05). In conclusion, the benefic effects of functional exercise were not improved by combination with LLLT.     

Glycemic Control after Sleeve Gastrectomy and Roux-En-Y Gastric Bypass in Obese Subjects with Type 2 Diabetes Mellitus

Background

Roux-en-Y gastric bypass (LRYGB) has weight-independent effects on glycemia in obese type 2 diabetic patients, whereas sleeve gastrectomy (LSG) is less well characterized. This study aims to compare early weight-independent and later weight-dependent glycemic effects of LRYGB and LSG.

Methods

Eighteen LRYGB and 15 LSG patients were included in the study. Glucose, insulin, GLP-1, and GIP levels were monitored during a modified 30 g oral glucose tolerance test before surgery and 2 days, 3 weeks, and 12 months after surgery. Patients self-monitored glucose levels 2 weeks before and after surgery.

Results

Postoperative fasting blood glucose decreased similarly in both groups (LRYGB vs. SG; baseline—8.1?±?0.6 vs. 8.2?±?0.4 mmol/l, 2 days—7.8?±?0.5 vs. 7.4?±?0.3 mmol/l, 3 weeks—6.6?±?0.4 vs. 6.6?±?0.3 mmol/l, respectively, P <?0.01 vs. baseline for both groups; 12 months—6.6?±?0.4 vs. 5.9?±?0.4, respectively, P <?0.05 for LRYGB and P <?0.001 for LSG vs. baseline, P =?ns between the groups at all times). LSG, but not LRYGB, showed increased peak insulin levels 2 days postoperatively (mean?±?SEM; LSG +?58?±?14%, P <?0.01; LRYGB ??8?±?17%, P =?ns). GLP-1 levels increased similarly at 2 days, but were higher in LRYGB at 3 weeks (AUC; 7525?±?1258 vs. 4779?±?712 pmol?×?min, respectively, P <?0.05). GIP levels did not differ. Body mass index (BMI) decreased more after LRYGB than LSG (??10.1?±?0.9 vs. ??7.9?±?0.5 kg/m², respectively, P <?0.05).

Conclusion

LRYGB and LSG show very similar effects on glycemic control, despite lower GLP-1 levels and inferior BMI decrease after LSG.

     

Evaluation of low-level laser therapy,platelet-rich plasma,and their combination on the healing of Achilles tendon in rabbits

Tendon repair is still one of the challenges for rehabilitation. Various treatments for tendon injuries have been used in recent decade. This study was established to investigate the effects of low-level laser therapy (LLLT), platelet-rich plasma (PRP) treatment alone, and using combined method on the healing of Achilles tendon in rabbits. Seventy-two healthy mature male white New Zealand rabbits were divided randomly into four groups of 18 animals each: control: partial tenotomy with no treatment, only 1 mL normal saline was injected on days 1, 8, and 15 at the site of splitting; PRP: partial tenotomy with PRP treatment on days 1, 8, and 15 at the site of splitting; LLLT: partial tenotomy with LLLT (K30 hand-held probe, AZOR, Technica, Russia, 650 nm, 30 mW, surface area?=?1 cm², 60 S/cm², energy density?=?1.8 J/cm²) for 15 consecutive days; LLLT?+?PRP: partial tenotomy with LLLT?+?PRP. At the end of trial, the rabbits were euthanatized and tendon specimens were harvested and were submitted for histopathological evaluation, hydroxyproline levels, and biomechanical measurement. The Tukey post hoc test was performed. The results for these parameters showed that PRP or LLLT alone has significant advantages over untreated animals (P?<?0.05). Furthermore, it was found that the combined treatment with PRP and LLLT is even more efficient. There was no significant difference (P?>?0.05) between the two groups of LLLT and PRP. However, the treatments combining PRP and LLLT showed significant results in comparison of PRP or LLLT alone (P?<?0.05). Our results demonstrate that the healing time of injured tendon decreases by using the two therapies combined.     

Photobiomodulation increases mitochondrial citrate synthase activity in rats submitted to aerobic training

This study investigated the effects of photobiomodulation by low-laser laser therapy (LLLT) on the activities of citrate synthase (CS) and lactate dehydrogenase (LDH) and the anaerobic threshold (AT) in rats submitted to treadmill exercise. Fifty-four rats were allocated into four groups: rest control (RCG), rest laser (RLG), exercise control (ECG), and exercise laser (ELG). The infrared LLLT was applied daily on the quadriceps, gluteus maximum, soleus, and tibialis anterior muscles. Muscle samples (soleus, tibialis anterior, and cardiac muscles) were removed 48 h after the last exercise session for spectrophotometric analysis of the CS and LDH. The CS activity (μmol/protein) in ELG (16.02 and 0.49) was significantly greater (P?<?0.05) than RCG (2.34 and 0.24), RLG (6.25 and 0.17), and ECG (6.76 and 0.26) in the cardiac and soleus muscles, respectively. The LDH activity (in 1 Mm/protein) in soleus muscle was smaller (P?<?0.05) for ELG (0.33) compared to ECG (0.97), RLG (0.79), and RCG (1.07). For cardiac muscle, the LDH activity was smaller (P?<?0.05) in ELG (1.38) compared to ECG (1.91) and RCG (2.55). The ECG and ELG showed increases in the maximum speed and a shift of the AT to higher effort levels after the training period, but no differences occurred between the exercised groups. In conclusion, the aerobic treadmill training combined with LLLT promotes an increase of oxidative capacity in this rat model, mainly in muscles with greater aerobic capacity.     

Effect of prior application with and without post-injury treatment with low-level laser on the modulation of key proteins in the muscle repair process

The aim of the present study was to evaluate the effects of LLLT prior to muscle injury with and without post-injury irradiation on the expression of isoforms of myosin heavy chain (MyHC), calcineurin (CaN), and myostatin during the repair process. Wistar rats were divided into five groups: control (n?=?7); injury (n?=?21); LLLT + injury (n?=?21); injury + LLLT (n?=?21), and LLLT + injury + LLLT (n?=?21). Cryoinjury was performed on the tibialis anterior (TA) muscle. The injured groups were euthanized at 3, 7, and 14 days after injury. LLLT was performed using an infrared laser (780 nm) with the following parameters: 10 J/cm², 40 mW, 10 s per point, 8 points, and 3.2 J of total energy. At the end of each period, the TA muscle was removed for the analysis of MyHC, CaN, and myostatin gene expression using real-time PCR. The data were tested statistically by Kruskal-Wallis with Dunn’s post hoc test (p?<?0.05). The results demonstrated that prior irradiation reduced the mRNA expression of all proteins at 3 days. Post irradiation reduced the mRNA expression of MyHC-1, MyHC-2a, MyHC-2b, and CaN at 7 days. Prior irradiation combined with post-injury irradiation reduced the mRNA expression of MyHC-2x and CaN at 14 days and increased the mRNA expression of myostatin in the same period. In conclusion, different protocols of photobiomodulation can modulate the expression of the different isoforms of MyHC, CaN, and myostatin during the repair process. It is noteworthy that the combination of the prior and post-injury irradiation was the protocol that most promoted changes in the final phase of the repair process.     

Increase in the nitric oxide release without changes in cell viability of macrophages after laser therapy with 660 and 808 nm lasers

The aim of this study was to evaluate the influence of low-level laser therapy (LLLT) with different parameters and wavelengths on nitric oxide (NO) release and cell viability. Irradiation was performed with Ga-Al-As laser, continuous mode and wavelengths of 660 and 808 nm at different energy and power densities. For each wavelength, powers of 30, 50, and 100 mW and times of 10, 30, and 60 s were used. NO release was measured using Griess reaction, and cell viability was evaluated by mitochondrial reduction of bromide 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) to formazan. LLLT promoted statistically significant changes in NO release and MTT value only at the wavelength of 660 nm (p?<?0.05). LLLT also promoted an increase in the NO release and cell viability when the energy densities 64 (p?=?0.04) and 214 J/cm² (p?=?0.012), respectively, were used. LLLT has a significant impact on NO release without affecting cell viability, but the significance of these findings in the inflammatory response needs to be further studied.     

Greater Curvature Plication with Duodenal–Jejunal Bypass: a Novel Metabolic Surgery for Type 2 Diabetes Mellitus

Objective

The study investigated the use of great curvature plication with duodenal–jejunal bypass (GCP-DJB) in a type 2 diabetic with obesity rat model.

Methods

Twenty-two Sprague-Dawley rats were given a high fat and sugar diet with subsequent intraperitoneal injection of a small dosage of streptozotocin (30 mg/kg) and randomly assigned to either GCP-DJB (n?=?12) or Sham surgery (n?=?10). Body weight, peripheral blood glucose, and fasting serum insulin were assayed, and insulin resistance index (IRI) was calculated, before and at 1, 2, 4, and 8 weeks after surgery.

Results

No differences were found in the preoperative characteristics of the two groups (P?>?0.05). At week 1, the body weights decreased significantly, but there was no significant difference between the two groups (P?>?0.05).The fasting blood glucose was significantly lower in the GCP-DJB than in the Sham group (P?<?0.05), serum insulin levels were higher (P?<?0.05), and IRI began to decline (P?<?0.05). From 2 to 8 weeks, the body weight of Sham group gradually recovered and continued to rise, while the GCP-DJB group remained at a relatively lower state. Compared to the Sham group, the body weight, fasting blood glucose as well as IRI of GCP-DJB rats had significantly decreased (P?<?0.05). But, the fasting insulin concentrations had significantly increased (P?<?0.05).

Conclusion

This novel GCP-DJB procedure established a stable animal model for the study of metabolic surgery to treat type 2 diabetes mellitus (T2DM).

     

The effect of low-level laser therapy on oxidative stress and functional fitness in aged rats subjected to swimming: an aerobic exercise

The aim of the present study was to determine whether low-level laser therapy (LLLT) in conjunction with aerobic training interferes with oxidative stress, thereby influencing the performance of old rats participating in swimming. Thirty Wistar rats (Norvegicus albinus) (24 aged and six young) were tested. The older animals were randomly divided into aged-control, aged-exercise, aged-LLLT, aged-LLLT/exercise, and young-control. Aerobic capacity (VO₂max^0.75) was analyzed before and after the training period. The exercise groups were trained for 6 weeks, and the LLLT was applied at 808 nm and 4 J energy. The rats were euthanized, and muscle tissue was collected to analyze the index of lipid peroxidation thiobarbituric acid reactive substances (TBARS), glutathione (GSH), superoxide dismutase (SOD), and catalase (CAT) activities. VO₂ ^0.75max values in the aged-LLLT/exercise group were significantly higher from those in the baseline older group (p <0.01) and the LLLT and exercise group (p <0.05). The results indicate that the activities of CAT, SOD, and GPx were higher and statistically significant (p <0.05) in the LLLT/exercise group than those in the LLLT and exercise groups. Young animals presented lesser and statistically significant activities of antioxidant enzymes compared to the aged group. The LLLT/exercise group and the LLLT and exercise group could also mitigate the concentration of TBARS (p?>?0.05). Laser therapy in conjunction with aerobic training may reduce oxidative stress, as well as increase VO2 ^0.75max, indicating that an aerobic exercise such as swimming increases speed and improves performance in aged animals treated with LLLT.     

Comparison of Vela and holmium laser enucleation of the prostate: a retrospective clinical trial with a 12-month follow-up

Purpose

This study aimed to estimate the validity and applicability of Vela laser enucleation of the prostate (VoLEP) in the management of benign prostatic hyperplasia (BPH).

Methods

A retrospective chart review of 112 patients with BPH who underwent VoLEP (n?=?60) or holmium laser enucleation of the prostate (HoLEP) (n?=?56) was conducted at our institution from January 2015 to June 2015. The general and perioperative characteristics of the patients were collected. The 12-month follow-up data, including the lower urinary tract symptom (LUTS) indexes (International Prostate Symptom Score [I-PSS], quality-of-life [QoL] score and maximum flow rate [Qmax]), as well as rates of perioperative and late complications, were analyzed.

Results

No significant differences were observed in pre- and perioperative parameters, including operation time (58.05?±?10.14 vs. 60.14?±?12.30 min, P?=?0.44), serum sodium decrease (3.49?±?0.83 vs. 3.48?±?0.84 mmol/L, P?=?0.97), hemoglobin decrease (1.28?±?0.38 vs. 1.24?±?0.77 g/dL, P?=?0.71), catheterization time (3.63?±?1.10 vs. 3.89?±?1.11 days, P?=?0.21) and hospital stay (4.57?±?1.25 vs. 4.68?±?1.18 days, P?=?0.63) between the two groups of patients. Compared with the HoLEP group, the noise during operation was lower in VoLEP group (47.22?±?10.31 vs. 59.45?±?9.65 db, P?<?0.05). During 1, 6 and 12 months of follow-up visits, the LUTS indexes (I-PSS, QoL score and Qmax) were remarkably improved in both groups when comparing with the baseline values. Furthermore, LUTS indexes were comparable in both groups (P?>?0.05).

Conclusion

Similarly as the holmium laser, the Vela laser is a potent, safe, efficient durable and surgical treatment option for minimally invasive surgery in patients with BPH-induced LUTS.

     

High final energy of gallium arsenide laser increases MyoD gene expression during the intermediate phase of muscle regeneration after cryoinjury in rats

The aim of this study was to determine the effects of gallium arsenide (GaAs) laser on IGF-I, MyoD, MAFbx, and TNF-α gene expression during the intermediate phase of muscle regeneration after cryoinjury 21 Wistar rats were divided into three groups (n?=?7 per group): untreated with no injury (control group), cryoinjury without GaAs (injured group), and cryoinjury with GaAs (GaAs-injured group). The cryoinjury was induced in the central region of the tibialis anterior muscle (TA). The region injured was irradiated once a day during 14 days using GaAs laser (904 nm; spot size 0.035 cm², output power 50 mW; energy density 69 J cm^?2; exposure time 4 s per point; final energy 4.8 J). Twenty-four hours after the last application, the right and left TA muscles were collected for histological (collagen content) and molecular (gene expression of IGF-I, MyoD, MAFbx, and TNF-α) analyses, respectively. Data were analyzed using one-way ANOVA at P?<?0.05. There were no significant (P?>?0.05) differences in collagen density and IGF-I gene expression in all experimental groups. There were similar (P?<?0.05) decreases in MAFbx and TNF-α gene expression in the injured and GaAs-injured groups, compared to control group. The MyoD gene expression increased (P?=?0.008) in the GaAs-injured group, but not in the injured group (P?=?0.338), compared to control group. GaAs laser therapy had a positive effect on MyoD gene expression, but not IGF-I, MAFbx, and TNF-α, during intermediary phases (14 days post-injury) of muscle repair.