This PDF file contains the front matter associated with SPIE Proceedings Volume 10582, including the Title Page, Copyright information, Table of Contents, Introduction, and Conference Committee listing.

Breast cancer related lymphedema (BCRL) is prevalent among breast cancer survivors, and may be painful and disfiguring with associated psychological impact. Previous research shows increasing use of low level laser therapy (LLLT), now commonly referred to as photobiomodulation (PBM) therapy for managing BCRL, in countries including the United States and Australia. However, conclusions were limited by the paucity, heterogeneity, and poor quality of previous studies. LLLT (PBM) has been barely used in clinical practice in New Zealand, and no clinical studies on LLLT (PBM) for BCRL have been conducted in this country. In order to promote this potentially useful treatment modality for BCRL patients, the Laser Lymphedema Trial Team at the University of Otago conducted a program to assess the effectiveness of LLLT (PBM) in management of BCRL. The program comprises three phases including a systematic review (completed), a feasibility study (completed), and a full-scale randomized controlled trial (proposed). This current paper provides an update on the program. Based upon the systematic review, LLLT (PBM) is considered a potentially effective treatment approach for women with BCRL; the review also indicated the need for further research including exploration of the relevance of dosage and other LLLT (PBM) parameters. The feasibility study demonstrated that it is feasible to conduct a fully powered RCT to definitively test the effectiveness of the additional use of LLLT (PBM) in the management of BCRL, and 114 participants will be needed at baseline in the main study. Currently, the full-scale RCT is under preparation.

Ultrasonography and MR imaging can help to identify the area and depth of different lesions, like injury, overuse, inflammation, degenerative diseases. The appropriate power density, sufficient dose and direction of the laser treatment can be optimally estimated. If required minimum 5 mW photon density and required optimal energy dose: 2-4 Joule/cm² wouldn’t arrive into the depth of the target volume - additional techniques can help: slight compression of soft tissues can decrease the tissue thickness or multiple laser diodes can be used. In case of multiple diode clusters light scattering results deeper penetration. Another method to increase the penetration depth is a second pulsation (in kHz range) of laser light. (So called continuous wave laser itself has inherent THz pulsation by temporal coherence). Third solution of higher light intensity in the target volume is the multi-gate technique: from different angles the same joint can be reached based on imaging findings. Recent developments is ultrasonography: elastosonography and tissue harmonic imaging with contrast material offer optimal therapy planning. While MRI is too expensive modality for laser planning images can be optimally used if a diagnostic MRI already was done. Usual DICOM images offer “postprocessing” measurements in mm range.

Antimicrobial photodynamic therapy (aPDT) is one of the treatment options of local infections. Conventional aPDT systems have physical limitations such as low light penetration and the need for long irradiation time to achieve the necessary light dose. With new forming specific complex of methylene blue dye molecules it is possible to reach efficient excitation processes at 810nm. At 810nm, there is increased light penetration depth in comparison to 670nm. This means that we are now able to excite the sensitizer in deeper areas and activate it transgingivally. Purpose Preserving teeth with complicated gangrene is a great challenge if root canal is obstructed. Lacking the possibility to perform the conventional mechanical cleaning of root canals. we have used infrared photodynamic therapy for elimination radicular bacterial infiltration Materials and methods We investigated 14 cases with complicated gangrene and totally or partially obstructed root canal. We deposited the sensitizer – Photolase Photolase GMBH Germany – in the pulp chamber and closed it for a week. This procedure was repeated three times. After the sensitizer penetrated we applied the light. We used G-Box 810 nm laser – Gigaa Laser China – at 0,8W/cm² , 40s buccal and 40s oral side. Results 6 month later we performed follow-up CBCT. Out of 14 cases significant healing was detected in 10. In 4 cases no change was observable. Discussion and conclusion Infrared aPDT seems effective in eliminating bacterial infiltrations in deeper areas. It can be a minimal invasive method in the case of obstructed root canals.

The Low Level Laser Therapy (LLLT) is an innovative and increasing therapeutic technique in Veterinary Medicine. As in Human Medicine, the low power red/near-infrared laser light could be used to reduce inflammatory conditions, induce analgesia and promote damaged tissues repair, both in conventional animals like horses, dogs and cats and in unconventional ones, including reptiles, birds and exotic mammals. Since A.Eistein (1917) and E.Mester (1968) built its physical and biochemical fundamentals, a growing number of researches, over the years, have expanded the knowledge of the molecular process considered today at the basis of the macroscopic therapeutic effects. Producing a photochemical tissue interaction, laser light is absorbed by the mitochondrial respiratory chain stimulating the generation of ATP, ROS and NO; this determines a modulation in gene expression of proteins playing key roles in cellular processes as tissue repair, inflammatory response and pain control. Different animal pathological conditions could significantly benefit from this therapy, such as acute/chronic muscle-skeletal disorders, dental afflictions, dermatitis, otitis, stomatitis and different kind of skin lesions, as traumatic or post-operative ones. Furthermore, other significant applications are developing scientifically: the treatment of internal organ diseases, the regenerative effects on nervous tissue and the possibility of a beneficial cell-specific cytotoxicity, relevant for oncological cases, are some of these. A high-quality research is therefore crucial for this quickly expanding field of Veterinary Medicine, in order to find the most effective protocols and the ideal doses for each pathological conditions, aiming to always ensure the best and up-todate animal care.

Delay in wound healing has been observed in the hypothyroidism disfunction. Laser light can modulate various biological phenomena acting on different cell types. However, there are few reports in the literature regarding the effects of laser on wound healing of hypothyroid models. This study aimed to evaluate the differences in reepithelialization process of cutaneous wounds on hypothyroid and euthyroid rats treated with laser phototherapy. Forty-eight rats were divided into two main groups: euthyroid (EU) and hypothyroid (HYPO). Hypothyroidism was induced by Thyroidectomy. Each group was divided into subgroups: control (without laser) and laser groups. Standard surgical wound was created on the dorsum of each rat. The irradiation protocols (λ660 nm, 40 mW, CW; 10 J/cm²) was carried out immediately after wounding and repeated every 24h during 3 and 7 days. After animal death, specimens were taken, routinely processed, cut, stained with hematoxylin-eosin, and underwent histological analysis. Three days after the surgery, it was possible to observe initial reepithelialization in more advanced stages in the wound area of the irradiated hypothyroid group when compared to control hypothyroid group (p<0.05). No significant difference was found in the experimental period of 7 days among the groups. It was concluded that the laser light did influence reepithelialization process on hypothyroid rats in early stages of healing process.

The repair of bone tissue is complex and can be influenced by several local and systemic factors that can delay the repair. Laser and LED phototherapies have shown positive results in the repair of bone tissue. The aim of this study was to evaluate, through Raman spectroscopy, the influence of laser (λ780 nm) and LED (λ850 nm) phototherapies in the repair of surgical defects in femurs of euthyroid and hypothyroid rats. Thirty Albinus Wistar rats were randomly divided into 6 groups. The animals of the hypothyroid groups were submitted to surgical removal of the thyroid gland. After general anesthesia, a surgical bone defect was created in the femur of each animal and filled with blood clot in all groups. In group I (Euthyroid) the defect was created in euthyroid animals; In Group II (Hypo) the defect was created in hypothyroid animals; In Group III (Euthyroid Laser) the defect was irradiated with Laser; on Group IV (Hypo Laser) the defect was made in a hypothyroid animal and irradiated with Laser; on Group V (Euthyroid LED) the defect was irradiated with LED and on Group VI (Hypo LED) the defect was created in hypothyroid animals and LED irradiated. Irradiation was carried out at every 48-h for 15 days. Specimens were taken and stored in liquid nitrogen. Intensity of peaks of phosphate HA (~960 cm^-1), carbonated HA (~1,070 cm^-1) and collagen (~1,414 cm^-1) were measured by Raman Spectroscopy. The results showed that the health status had significant influence all peaks. Irradiation influenced only the peak of ~1454 cm^-1. It is concluded that phototherapies influences bone repair in cases of thyroid diseases.

Genital Chlamydia Trachomatis infection is one of the most common sexually transmitted infections with more than 50 million new cases occurred globally every year. Underdiagnosed and untreated, it can generate long term severe complications including PID, infertility, ectopic pregnancy and chronic pelvic pain. Among 20 patients diagnosed with PID and infertility in our medical office during one year, we selected a study group of 10 patients with genital Chlamydia Trachomatis infection. The diagnostic methods used were anamnesis, clinical examination, Pap smear, bacteriological and serological tests, ultra sound examination. The group of patients selected was monitored for one year. The treatment took into account general measures for both partners and specific measures (antibiotic treatment and focused laser therapy). The initial group was split in two, group A treated only with antibiotics and group B treated with both antibiotics and laser therapy. All the 5 patients of group B presented an improvement of the clinical manifestations and 3 of them ended up with pregnancy. On the other hand, in group B, only one patient manifested total disappearance of pains and the infertility persisted for all. It is noteworthy that the association of laser therapy in the treatment of Chlamydia Trachomatis infection has brought significant improvement in the inflammatory processes of internal genitalia (PID) and in the fertility of the couple.

Oral mucositis (MO) is considered to be the most severe stomatologic complication associated with antineoplastic treatment, which may lead to its interruption. Several current clinical protocols have aproven the benefits of Laser Photobiomodulation (LP) in the prevention and control of MO, due to its analgesic and anti-inflammatory effects and its stimulation of mesenchymal cells proliferation. The objective of this study was to evaluate the action of laser in initial events of chemo-induced MO. Eight Hamsters were divided into 2 groups (G): GI positive control (induction of MO) and GII Laser (induction of MO + Laser therapy). MO was induced by two injections of 5-Fluorouracil followed by grooves in the mucosa of the cheek pouch. The PL (Diode Laser of Gallium and Aluminum Arsenide, λ660nm, 40mW, 2,4J/cm² ) was performed on day 0 of the experiment and every 48 hours until day 6. On day 7 the mucosa was photographed for clinical analysis according to Lima et al., 2005 and the animals were killed, for bag removal and histological processing for Hematoxylin and Eosin (H / E) staining. After statistical analysis (Fischer's Exact) with a significance level 0.5%, it was concluded that the LP, according to the adopted protocol, was able to prevent MO, and most hamsters showed no visible clinical changes in the cheek pouch. Histologically, it was observed that LP reduced angiogenesis and recruitment of inflammatory cells in G2. According to the results obtained LP was effective in preventing and reducing the severity of oral mucositis.

Obese people present a greater risk of developing other systemic diseases and comorbidities such as compromising the tissue repair process. Laser phototherapy can contribute to this repair by improving cellular functions, since stem cells may play an important role in repair due to their pluripotent potential. In this way, the influence of Laser Phototherapy (LP) was evaluated in the tissue repair of rats submitted to a hyperlipid diet through CD49 immunostaining for adipose stem cells. Forty-eight Wistar albinus rats were divided into two experimental groups: Standard Diet (SD) and Hyperlipid Diet (HD) for 20 weeks. After this period, excisional dorsal cutaneous wounds of 1 cm2 were made. The groups were subdivided into control and laser, the laser groups were irradiated (Diode Laser of Gallium and Aluminum Arsenide, λ660nm, 40mW, 6J / cm2) immediately after the surgery and every 48 hours. A group of rats were killed on day 7 and the other group on day 14 and the specimens processed by the immunohistochemical technique. The SD group presented antibodies marked with moderate to intense intensity, whereas in the HD group the weak staining for the time of 14 days prevailed. The irradiation protocol employed had no influence on the CD49 marker when compared to the control and irradiated groups over the same period. According to the methodology used and the results obtained it is concluded that laser light does not influence the recruitment of adipoderivative stem cells for the tissue repair process.

Aim of the study was to compare the efficacy of a muscle shortening maneuver (MSM) with the efficacy of a topical NSAID (flurbiprofen) in patients with subacromial impingement syndrome (SIS). The effects of these therapies were evaluated by sonographic exam (US). SIS was diagnosed by US in 78 patients with painful shoulder. Thirty patients (first group) were treated with topical flurbiprofen for 15 days. Forty-eight patients (second group) were treated with MSM, which was performed once. The shoulder was analyzed in all patients by US before and after treatment. Before treatment and 15 days after treatment, pain by Visual Analogue Scale (VAS), range of motion (ROM) and Neer’s Test were evaluated. Pain was decreased by both treatments. In only 8 patients of the first group, the encroachment of acromion into the rotator cuff was no more detectable by US after the treatment; ROM increased (> 45°) only in 11 patients (36%) and the width of subacromial-subdeltoid bursa (SSB) was not significantly reduced. At variance with the results obtained in the first group, in all patients of the second group the encroachment of acromion was no more detectable by US, ROM increased (> 45°) and the width of SSB was significantly reduced after the maneuver. Both topical flurbiprofen and MSM were helpful in pain control, but better results, with decrease of width of SSB assessed by US, were obtained by MSM.

The extraordinary properties of size-tunable nanoparticles (NPs) have given rise to their widespread applications in Nanophotonics, Biomedicine, Plasmonics etc. Semiconductor and metal NPs have found a number of significant applications in the modern biomedicine due to ultrasmall sizes (1-10 nm) and the size-dependent flexibility of their optical properties. In the present work passive Q-switched Nd:YAG pulsed laser was used to synthesize NPs by method of laser ablation in different liquids. For cases of hybrid metal NPs we have demonstrated that plasmon resonance can be modified and tuned from the plasmon resonances of pure metal NPs. The shifted plasmon resonance frequency at 437 nm for Au–Ag hybrid NPs, and 545 nm for Au–Cu hybrid NPs have been observed. Effectiveness of biotissue ablation in the case of the tissue sample that colored with metal NPs was approximately on 4-5 times larger than for the sample with non-colored area. Laser welding for deep-located biotissue layers colored by metal NPs has been realized. The luminescence properties of the colloidal hybrid Si–Ni nanoparticles’ system fabricated by pulsed laser ablation are also considered. The red-shifted photoluminescence of this system has been registered in the blue range of the spectrum because of the Stark effect in the Coulomb field of the charged Ni nanoparticles. Summarizing, the knowledge of peculiarities of optical properties of hybrid NPs is very important for biomedical applications. More complex nanoassemblies can be easily constructed by the presented technique of laser synthesis of colloidal QDs including complexes of NPs of different materials.

Many factors can influence the radiant power delivered by the low-level laser therapy (LLLT) equipment, such as its cleaning and condition, as well as the use of plastic films for protecting the laser or even its time of use. Radiant power is an important factor to consider because it affects the amount of energy delivered to the target tissue. The difference between real radiant power (RRP) and nominal radiant power (NRP) may interfere in the expected results, because the delivered energy is different from the desired energy. Purpose: The objective of this study was to compare the NRP with the RRP offered by LLLT devices under clinical conditions of use. Material and Methods: For data collection to this study, 61 LLLT devices used in private and public dental practices in the state of Tocantins, Brazil, were evaluated. Three consecutive power measurements were performed at one-minute intervals and then the average of the measured power was calculated. The RRP was compared to the NRP. Results: The equipment presented NRP from 30 to 500mW while RRP ranged from 17.3 to 107.0mW. Discussion and Conclusion: The mean power measured in clinical conditions of use of the laser equipment was different from the nominal power reported by the manufacturers of the devices (p<0,01). The RRP ranged between 12.92% and 107% of NRP. This fact is worrisome, since one of the most important parameters for the success of the treatment of an injury using LLLT is the energy (power x time) delivered. These findings reinforce the need of calibrating the equipment before each laser application in order to avoid failures in the therapeutic conduct.

The complexity of the biological tissue spectroscopic analysis due to the overlap of biological molecules’ absorption spectra, multiple scattering effect, as well as measurement geometry in vivo has caused the relevance of this work. In the neurooncology the problem of tumor boundaries delineation is especially acute and requires the development of new methods of intraoperative diagnosis. Methods of optical spectroscopy allow detecting various diagnostically significant parameters non-invasively. 5-ALA induced protoporphyrin IX is frequently used as fluorescent tumor marker in neurooncology. At the same time analysis of the concentration and the oxygenation level of haemoglobin and significant changes of light scattering in tumor tissues have a high diagnostic value. This paper presents an original method for the simultaneous registration of backward diffuse reflectance and fluorescence spectra, which allows defining all the parameters listed above simultaneously. The clinical studies involving 47 patients with intracranial glial tumors of II-IV Grades were carried out in N.N. Burdenko National Medical Research Center of Neurosurgery. To register the spectral dependences the spectroscopic system LESA- 01-BIOSPEC was used with specially developed w-shaped diagnostic fiber optic probe. The original algorithm of combined spectroscopic signal processing was developed. We have created a software and hardware, which allowed (as compared with the methods currently used in neurosurgical practice) to increase the sensitivity of intraoperative demarcation of intracranial tumors from 78% to 96%, specificity of 60% to 82%. The result of analysis of different techniques of automatic classification shows that in our case the most appropriate is the k Nearest Neighbors algorithm with cubic metrics.

Preterm patients can have an higher risk of fatalities and can be subjected to long-term disability. With many organs still in the phase of development, the earlier the delivery, the higher the risk and they are therefore hospitalized in specialized neonatal intensive care units) where heart rate and lungs activity are continuously assessed. These are mostly monitored by set of electrodes placed in contact with skin (two in thorax area and one in abdominal area). This paper address the problem of preterm cardiac and respiratory monitoring in a patient with severe skin disorders who can not monitored with standard electrodes because of his dry, thickened, scaly skin. As a solution, we propose a fully non-contact measurement method, based on laser Doppler vibrometry, able to continuously record the movements of wall-chest and extract from this signal, the heart rate and the respiratory activity of the patient. The results show a good agreement between the standard contact measurement methods and the proposed one (no statistical difference between data) with a data uncertainty of 2.9% for the heart rate data and of 9.5% for the respiration rate (k=2), in line with the classical measurement methods.

Lips are the component of the oral cavity which synthesizes more functions and emotions. The nonverbal communication is established by the body, every movement gesture, posture and facial expression which shows a willingness to communicate directly or subtly, consciously or unconsciously. The smile is one of the expressions that attract us the most, for its simplicity and mainly for its puzzle. In Lips aging implies a loss of mucous membranes’ density; lips’ dehydrate and resect themselves, reducing its’ thickness which causes an appearance of aging of the all face. The demands of public opinion of being young and stay young are becoming more and more pressing, therefore it is necessary to meet this demand. The responsibility of achieving this task is up to the doctor, the anti-aging medicine and the actual existing physical means, which are available to correct and prevent this disease. Having the possibility of using the new picoseconds Nd-Yag Laser in Lips’ rejuvenation we must use them together and in accordance between them and the guideline we presented what we believe to be the guideline which allows us to obtain good results in a new and simple effective treatment that can be proved by the major aspect of the lip and by evidence and monitoring that we went through for about ten month. Obtained results of labial cracks’ disappearance inside of the red mucosa increase in lips’ volume and contour and disappearance of oral wrinkles creates an aesthetic appearance witch is remarkable. This is a non invasive method with minimal complications with low morbidity and in our opinion superior results when compared to other traditional methods considered soft tissue augmentation including peelings, botox injections, injectable fillers such as hyaluronic acid injections temporary and permanent injectable bio-implants, bio- catalysts and even surgery of the upper lip.

To achieve a unique goal in the treatment of varicose veins in order to obtain the desired result, we use EVLA as the execution of a single treatment that is optimized to treat varicose veins, in which we can treat different kind of patients which we have treated from November 2001 to March 2017. So 3486 documentary cases were carried out with this treatment and the analysis of these cases was the object of this retrospective observational study that allows doctors to understand the surroundings of this procedure on his road to desired perfection. The comparison of the first 8 years of clinical execution with the second ones, allows us to obtain postulates that can serve as guide lines for the understanding of the main fields involved, whether they are the human or the social, economic or even the technician execution needed to obtain the results that allow us to well founded considerations about the validity of this method, as well as we can think how to improve or execute it in order to obtain even better results. The aim of our comparison is to try to understand the clinical and physical contents of these contributions and obtained knowledge that allows the doctors with the bridge that overlaps these different backgrounds.

Wound contraction of both traumatic and surgical origin may reduce or limit the function of the tissue. Myofibroblasts are cells involved on the process of wound contraction, which is smaller on CO₂ Laser wounds. The aims of this study were to quantitative and statistically assess the presence of myofibroblasts on both conventional and CO₂ Laser wounds. Thirty-two animals (rattus norvegicus) were divided into four groups and operated using either the CO₂ Laser (groups A1 and A2) or conventional scalpel (groups B1 and B2). The animals were sacrificed eight days post-operatively (groups: A1 and B1) and 14^th days after surgery (groups: A2 and B2). The spec imens we re routinely processed to wax and stained with a-Smooth Muscle Actin (aSMA) and analyzed under light microscopy (40X). Two standard areas around the wound of each slide were selected and used to count the number of myofribroblasts present using a calibrated eyepiece and a graticule. The number of myofibroblasts at day eight was significantly higher than at day 14^th. Comparison of the two techniques at day eight showed significant differences between the two groups (Laser, p=0.007 and scalpel, p=0.001). The number of cells present on group B1 was significantly higher than group A1 (p=0.001). However at the 14^th day there was no such difference (p=0,072). It is concluded that the small number of myofibroblasts at day eight after wounding with the CO₂ Lasermay be the reason why contraction on this wound is smaller than the one observed in conventional surgery.

Background: Lithium di-silicate dental ceramic bonding, realized by using different resins, is strictly dependent on micro-mechanical retention and chemical adhesion. The aim of this in vitro study was to investigate the capability of a 1070 nm fibre laser for their surface treatment. Methods: Samples were irradiated by a pulsed fibre laser at 1070 nm with different parameters (peak power of 5, 7.5, and 10 kW, repetition rate (RR) 20 kHz, speed of 10 and 50 mm/sec, and total energy density from 1.3 to 27 kW/cm²) Subsequently, the surface modifications were analysed by optical microscope, scanning electron microscope (SEM) and energy dispersive X-ray Spectroscopy (EDS). Results: With a peak power of 5 kW, RR of 20 kHz, and speed of 50 mm/sec, the microscopic observation of the irradiated surface showed increased roughness with small areas of melting and carbonization. EDS analysis revealed that, with these parameters, there are no evident differences between laser-processed samples and controls. Conclusions: A 1070 nm fibre laser can be considered as a good device to increase the adhesion of lithium di-silicate ceramics when optimum parameters are considered.