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Welcome, dear readers, to the first issue of Volume 24 of the journal. It is hard to believe that three months have passed since I wrote to you in the last issue of Volume 23 … time really does fly, and here we are at the end of March, 2015, already one-quarter of the way through the UN-designated International Year of Light and Light-Based Devices. As you are all aware, for the past few years the journal has been offering an annual set of awards together with cash prizes, one for the Best Paper, and two for Good Papers published in any one volume of the journal. Last year (Volume 23) was supposed to be the final year for this initiative as the journal had set aside only a certain amount of funds, but as I wrote in my previous Editorial, I believe that these awards are a powerful incentive for authors to contribute their experience and research to the journal and to you, so I am taking over the role of the award sponsor. Thus, from this year and the current volume, the awards will be known as the Ohshiro-Laser Therapy Awards. In any event, the results for the 2014 Laser Therapy awards have now been compiled from all the votes lodged by the Laser Therapy International Editorial Board Members who serve as the Award Adjudicators. In addition, since Volume 22, the younger authors contributing to the journal as first author have also enjoyed another set of awards thanks to the generosity of Professor Ming-Chien Kao with his Award for Young Researchers, and these results are also in. I am therefore pleased and honoured to present the results in resume in the table below: they are given in full elsewhere in the body of the journal. Sincere congratulations to the winners, and if you didn't win for Volume 23, now is your chance to get a paper in for Volume 24 (please see the announcement elsewhere in the journal for full details)! Winners of the Laser Therapy and Ming-Chien Kao Awards

Purpose: The aim of this umbrella review is to determine the effectiveness of LLLT in the treatment of LET and to provide recommendations based on this evidence. Methods: A comprehensive and systematic review was undertaken using Medline, EBSCO and EMBASE. Systematic reviews or meta-analysis were included if they compared Laser with at least one of the following: (i) placebo, (ii) no treatment, (iii) another treatment, conservative (physical therapy intervention or medical) or operative of LET. Principal outcomes included the assessment of short and long-term effect on functional status, pain, grip strength (pain-free or maximum) and a global measure (overall improvement). Results: Seven papers met the inclusion criteria for the umbrella review, Five papers were of moderate and two of low methodological quality. All reviews reported benefits associated with laser therapy Vs other intervention or placebo, however the significance of the identified benefits differed between studies and reviews. No review reported negative effects of laser therapy or harm to patients. All reviews noted significant variance between included studies with 2 reviews citing statistically significant heterogeneity. It is essential to consider this in the interpretation of these data. Conclusion: This umbrella review found poor results for the effectiveness of LLLT in the management of LET. Therefore, further research with well-designed RCTs is required to provide meaningful evidence on the effectiveness (absolute and relative) of LLLT for the management of LET.

Background and aims: There are many Q-switched lasers. The Q-switched ruby laser is the one most popularly used in dermatology, aesthetic surgery and plastic surgery, to remove pigmented lesions or tattoos. Correct and regular calibration of such a system is essential. However, some clinics fail to perform this with the excuse of having no measuring instrument (MI) in their offices or treatment rooms in some of their hospitals or clinics, or even the case of well-known medical universities in Japan. The present article explains the precise calibration procedure and beam pattern checking for the Q-switched ruby systems in the first author's clinic. Rationale: In the case of treatment with a medical laser, the calibration and the irradiated pattern (IP) check of the laser being used for treatment are the most important factors for treatment efficacy and safety. If these factors change, the treatment result could be different from that expected. Such kind of data are not acceptable as scientific information for a presentation or published paper. With such unreliable results and incorrect beam pattern, replicating such a study would be impossible Regular calibration check: In our clinic, we have 2 Q-switched ruby laser systems. On a daily basis, the beam patterns, both the optical axis of the beam and its treatment footprint, are checked on dedicated printed sheets and footprint paper, respectively, at the beginning of the day and after the last procedure. Every two weeks we calibrate our systems in-house using a precise MI. Every six months we calibrate the systems in-house with the MI, and then we send the systems back to the manufacturers for calibration. Once every year, we have our MI calibrated by an accredited facility in Japan. In this way, we are not only ensuring accurate and safe treatment for our patients, but we are also producing accurate system and treatment data which can be replicated by others, the basis of evidence-based medicine.

Welcome, dear readers, to the first issue of Volume 23 of Laser Therapy, and to the first issue of 2014, the Year of the Horse, which is now well and truly under way. “March,” they say, “comes in like a lion and goes out like a lamb.” There will be many people worldwide who have suffered from the intense weather phenomena, like raging Australian forest fires, the North American plunging temperatures and blizzards and the widespread hurricane-strength storms and flooding in the UK, who will be wishing that the “lamb” part of the saying should come true as quickly as possible. Our thoughts go out to all those who have suffered from calamitous weather-related events in these first months of 2014. As I write, Japan is unseasonably cold for March, with snow storms here and there. However, Nature presses on, and the cherry blossoms will very soon explode in Kyushu, to the south of Japan, so we can look forward to warmer and sunnier weather It is hard to believe that this is the 23rd year in which the journal has appeared, and it seems almost yesterday when we were discussing the possibility of publishing the journal with John Wiley and Sons of Chichester, UK: that process actually started in 1987, and we have come a long way since then. Now the journal has reached new peaks of excellence, and has garnered international recognition by the leading indexing services. None of this could have happened without papers to publish, and that is still the case, dear readers, so please, send in your papers! As you read this we are already one-quarter of the way through 2014, which means that you only have 9 months left to get your paper in to us, and qualify for entry to our two awards for selected papers: the Laser Therapy Best/Good Papers Award and the newly founded Ming-Chien Kao Award for Young Researchers. All you have to do is get you clinical or research findings down on paper, and send them in! The results of the adjudication panels for papers published in 2013 have been scored and totaled, so without further ado, here they are!

This Letter relates to the paper of Yuichi Miyamoto et al., “EFFECT OF 630-NM PULSED LASER IRRADIATION ON THE PROLIFERATION OF HeLa CELLS IN PHOTOFRIN®-MEDIATED PHOTODYNAMIC THERAPY” published recently in Vol. 20 (2). The authors investigated changes in cell proliferation following PDT using 630nm laser irradiation which was clinically found to induce no remarkable cell injury. They found that the viability of irradiated HeLa cells was greater than that of non-irradiated cells, i.e. an LLLT effect. They derived the conclusion that in PDT when light doses become remarkably low (deep within the tissue), pronounced LLLT effects and no cytotoxic effects are obtained. We would like to draw the attention of the readers to an old paper of us1) where we found that the proliferation rate of fibroblasts enriched with small amounts of hematoporphyrin derivatives (HPD) was increased following low intensity HeNe laser irradiation. PDT and LLLT are two edges of the same sword. In PDT, exogenous photosensitizers are introduced into the cells and then irradiated with wavelengths of visible or near infra-red (NIR) light to produce high amounts of ROS that are lethal to the cells. In LLLT, light is absorbed by endogenous cellular photosensitizers such as cytochromes, flavins, porphyrins and NADH.2) Since the amount of endogenous cellular photosensitizers is relatively small, low concentrations of ROS are generated. It is well established that ROS in minute concentrations stimulate cellular functions like proliferation.3) The fact that exogenous porphyrins combined with very low energy visible light enhance proliferation must be taken into account when using PDT. Cancerous cells enriched with small amounts of photosensitizers (like those at the border of a malignant tumor) may proliferate better after irradiation. For the same reason, LLLT should be avoided in the presence of cancerous cells.4) LLLT and PDT can be viewed as different zones of the well-known Arndt-Schultz (A-S) curve, (see e.g. Fig. 10 in the review of T. Ohshiro5). Zone 1, ascending part of the A-S curve: weak to moderate light doses and endogenous photosensitizers:, or very weak light doses adding exogenous photosensitizers, or moderate light doses adding minute amounts of exogenous photosensitizers lead to stimulation as in LLLT. Zone 2, the A-S curve descends back to the baseline: in this Zone, strong light doses and endogenous photosensitizers or moderate light doses adding small amounts of exogenous photosensitizers lead to neutralizing the stimulation obtained in Zone 1. Zone 3, the A-S curve descends below the baseline: in Zone 3, a further increase of the combined light and exogenous photosensitizer stimuli dosage leads to PDT.

Background Focal reactive gingival overgrowths (FRGO) are a common observation in a clinical dental practice that may occur in response to external and internal chronic stimuli in form of fibrous connective tissue lesions in the oral mucosa. Gingiva is the most commonly involved site of oral reactive lesions. For the confirmed diagnosis of FRGO not only clinical, but the histopathological presentation of the lesion plays a vital role. Various surgical treatment modalities like a scalpel, cryosurgery, electrosurgery, and lasers have been applied in the management of FRGO. The laser is new treatment modality being employed for treatment of FRGO. Case report The purpose of this paper is to attempt short review on FRGO with the management of FRGO using diode laser. Here, we present effective management of peripheral giant cell granuloma and peripheral ossifying fibroma using diode laser. The follow-up of 01year showed no recurrence in both the cases. Conclusions Diode soft tissue laser has added advantages like a bloodless surgical field, reduced bacteremia, minimal intra and postoperative discomfort over conventional modalities. Thus it is highly effective in the surgical management of FRGO.

BACKGROUND AND OBJECTIVES Autogenous gingival grafts are considered the "gold standard" for gingival augmentation, however they require a second surgical site for graft harvesting. Apically positioned flaps (APFs) represent an alternative method in soft tissue augmentation procedures. Limited information is available relative to the effectiveness of laser-mediated APF in augmenting keratinized gingiva (KG). The aim of this paper is to evaluate soft tissues changes following APF using CO2 laser in mandibular incisors with minimal KG and high labial frenum attachment. MATERIALS AND METHODS A total of 20 patients with minimal amount of KG (< 2 mm) on the labial aspect of one mandibular incisor and high buccal frenum insertion were selected for treatment. Only 19 completed the last follow-up visit. An APF consisting of a single superficial horizontal incision just coronal to the mucogingival junction using CO2 laser, elevation of a split-thickness flap, and suturing of the flap to the periosteum in an apical position was performed. The apico-coronal height of KG was measured at baseline, and at 3, 6 and 12 months postoperatively. RESULTS Uneventful healing was observed in all patients and an increase in KG of 2-3 mm was obtained. Most patients rated the procedure and the postoperative course as non painful. CONCLUSIONS CO2 laser-assisted APF procedure is a minimally invasive treatment modality associated with reduced risk of bleeding and predictable increase in the height of KG.

Purpose: This study evaluated the micro-tensile bond strength of new and previous composite resin restorations after surface treatment with diamond bur and Er,Cr:YSGG laser at different power settings (2,3 and 4 W). Materials and methods: Micro-hybride composite resin was inserted in metallic mold 5 ×5 ×15 mm and cured for 40 sec according to manufacturer's instruction.12 blocks were made. The bonded surfaces of the 12 blocks so obtained were subsequently ground using Silicon Carbide papers 1200 grit, for 15 seconds under running water. Then the samples randomly were divided into 4 groups: (G1) Bur-treated, (G2) Er,Cr:YSGG laser with power of 2 W and energy of 100 mJ, (G3) Er,Cr:YSGG laser with power of 3 W and energy of 150 mJ, (G4) Er,Cr:YSGG laser with power of 4 W and energy of 200 mJ. One sample of each group was analyzed by SEM while, after cutting the blocks to 1 mm2 of area samples, the others samples were mechanically tested by Universal testing machine with the speed of 0.5 mm per minute till fracture point. Data were analysed using One-Way ANOVA and Tukey Test. Results: T-test showed no significantly differences between G2 and G4(P=0.064) while G3 demonstrated significant differences than G2 (P=0.001) and G4(P=0.000) and also between samples treated with bur (G1) and G2 (P=0.242) ,G3 (P=0.000) ,G4 (P=0.829); G1 didn't significantly differ to G2 and G4(P>0.05), while G1 and G3(P

Background: Ion beam has been used in cancer treatment, and has a unique preferable feature to deposit its main energy inside a human body so that cancer cell could be killed by the ion beam. However, conventional ion accelerator tends to be huge in its size and its cost. In this paper a future intense-laser ion accelerator is proposed to make the ion accelerator compact. Subjects and methods: An intense femtosecond pulsed laser was employed to accelerate ions. The issues in the laser ion accelerator include the energy efficiency from the laser to the ions, the ion beam collimation, the ion energy spectrum control, the ion beam bunching and the ion particle energy control. In the study particle computer simulations were performed to solve the issues, and each component was designed to control the ion beam quality. Results: When an intense laser illuminates a target, electrons in the target are accelerated and leave from the target; temporarily a strong electric field is formed between the high-energy electrons and the target ions, and the target ions are accelerated. The energy efficiency from the laser to ions was improved by using a solid target with a fine sub-wavelength structure or by a near-critical density gas plasma. The ion beam collimation was realized by holes behind the solid target. The control of the ion energy spectrum and the ion particle energy, and the ion beam bunching were successfully realized by a multi-stage laser-target interaction. Conclusions: The present study proposed a novel concept for a future compact laser ion accelerator, based on each component study required to control the ion beam quality and parameters.

Background and aims: Electromyography (EMG) is considered the gold-standard for the evaluation of muscle activity. Transversal and dimensional changes of the muscle, during muscle activity, generate vibrational phenomena which can be measured by Laser Doppler Vibrometry (LDVi). There is a relationship between muscle contraction and vibrational activity, therefore, some information on fundamental muscle parameters can be assessed without contact with LDVi. In this paper, we explore the possibility to relate the EMG signal causing the muscle contraction and the vibrational activity also measureable on the muscle. A novel non-contact measurement method — Laser Doppler myography (LDMi) - aiming to measure the vibrational behavior of muscle during contraction, is presented herein. Correlations with some parameters normally measured with EMG are reported. Materials and methods: The proposed method has been compared with standard superficial EMG (sEMG). Signals produced with sEMG and laser Doppler myography have been simultaneously acquired and processed to test correlations on a population of 20 healthy volunteers. Tests have been carried out on the flexor carpi ulnaris and the tibialis anterior muscles (left and right). Results: Results show that it is possible to measure: The timing of muscle activation (max differences: 440 ms), the amplitude of the signals acquired during activation respect to the signals during rest (S/N), the correlation between the S/N of the sEMG and LDMi signals at different levels of force (P> 0.89), and to assess muscle fatigue. Conclusions: LDMi is a valid measurement technique for the assessment of muscle activity and fatigue. It is a non-contact method and this characteristic could suggest its use together with low level laser therapy pre-, intra- and post-LLLT sessions to evaluate the efficacy and effects of the treatments without the need for invasive electrodes.

This paper reports the findings obtained in our recent clinical study of the characteristics of low-level laser therapy (LLLT) and discusses the possibility of applying these findings to the treatment of previously unreported orthopedic diseases.Histological study of muscles: Following long-term (3-week or longer) irradiation, there was an increase in nerve activity, suggesting the possibility that irradiation have the potential to alter the distribution of the myofiber types.Application to a patient with osteoarthritis of the hip: The narrowing of the joint space and the range of motion of hip joint alleviated or improved and the pain lessened markedly.Application to patients with congenital clubfoot: The application of LLLT and corrective massage before the correction of deformities with a cast facilitated the correction, enabling further improvement in congenital clubfoot.The possibility of the application of LLLT in patients with osteoporosis: LLLT tended to stimulate ossification and suppress bone resorption temporarily, suggesting the feasibility of applying LLLT as a means of treating osteoporosis.The possibility of the use of LLLT applied to the neck for the improving the cerebral blood flow was evaluated in patients with spastic cerebral palsy, using single photon emission computed tomography.Better knowledge of the characteristics of light may expand the scope of application of phototherapy for other diseases.

The goal of this paper is to study the effect of phototherapy with near infrared laser on incidence of late radiation lesions of urinary bladder and rectum in patients with prostate cancer after external radiation therapy. The study was carried out at Department of New Technologies of Radiation Therapy. 559 patients with prostate cancer were treated with radiotherapy and hormonal therapy from January 2000 to June 2007. In 308 patients a “Lazernoe Solnyshko” laser apparatus was used (NIIEFA, λ = 890 nm, 45 mW, 10.8 J, duration of pulses 150 ns, frequency of pulses 3000 Hz, 16 radiating elements). The control group included 251 patients. Action of light was performed on the skin areas submitted to radiation therapy beginning from its 12th session during 4 minutes. In the control group the radiation damage of urinary bladder and rectum appeared in 7.6% and 10.7% of patients, while in the main group - in 1.95% and 2.92%, respectively (p < 0.01). Thus, the course of phototherapy with the near infrared low power laser at performance of radiotherapy decreases incidence of radiation damages of urinary bladder and rectum in patients with prostate cancer.

For appropriate treatment of severe burn injuries, noninvasive, real-time diagnosis of the wound status, e.g., injury depth, is required; however, modalities for quantitative evaluation are limited. In this paper, a new method for multifunctional diagnosis of burns based on photoacoustic measurement is described. When a burn wound is irradiated with a short light pulse that is selectively absorbed by blood, the light can efficiently propagate though the injured tissue layer due to occlusion of blood vessels and the light is absorbed by blood in the healthy tissue layer under the wound, emitting a photoacoustic (PA) wave through a thermoelastic process. The PA wave can be detected with an acoustic sensor on the wound and its propagation time provides information on the depth of injury. In addition, PA measurement at dual wavelengths, oxy- and deoxyhemoglobin absorption dominant wavelengths, can provide information on local hemodynamics, which is also important for wound management. The validity of these techniques was demonstrated by experiments using rat burn models. Furthermore, applicability of this measurement to thick burned skins was examined by experiments using a thick burn mimicking model. The results suggest that the present PA diagnosis technique can be applied to human skin burns.

As we approach the end of the third quarter of 2014, I look back over the last 2 decades and I am amazed, but proud and highly and gratified, at what Laser Therapy has accomplished in these 20 years. Of course, up till the first couple of years of the New Millennium we had a tremendous record, first under the steady hand of John Wiley and Sons of Chichester, UK, and then from Volume 6 with LT Publishers of Rishworth, Yorkshire as the publishing company and The University of Hokkaido Press as the printers. Then we had a small hiatus when the journal appeared to have disappeared, as it were. However, in 2004 I decided that it was time for the journal to ride again under its original masthead, and we put together the Laser Therapy Pilot Issue 2 which was sent out in 2004 as a sign that life was returning, and the Phoenix arose from its own ashes. During this past decade we have seen prompt and on-time quarterly publication of the journal from 14:1 in March 2005 all the way through till this issue. We have gone from a page count of 48 to 76 and occasionally 80 pages per issue. We became associated with the Japan Scientific and Technology Information Enumerator-Electronic (J-STAGE), and now every single issue of the journal from the first Pilot Issue in 1988 has been stored by J-STAGE in a digital format, and on-line searching is possible by author name or by keyword with free full-text PDF results available for every article older than 6 months under the free access credo (https://www.jstage.jst.go.jp/browse/islsm). The journal contents have achieved scientific recognition and are now indexed by both EmBase in Europe and PubMed Central in the USA. We are in communication with the Thomson-Reuter Web of Science, which will be the final step in the long task of getting an impact factor established for Laser Therapy. In these 20 years, we have never missed our deadline for a single issue, so I'd like sincerely and humbly to thank you, our dear and faithful readers, contributors and subscribers, because without your papers to publish the journal, and subscriptions to the journal to provide the income to keep Laser Therapy going, we would not have been able to accomplish what we have. I'd also like to thank the hard-working Editorial Team here at JMLL, whose hard work and dedication have helped keep the journal to its deadlines.

The exploitation of photobiology in medicine has been of great interest to mankind. There is a growing interest in the use of lasers for treatment purposes because of the photochemical alterations induced in biomolecules by light energy. In this paper we present our data on laser biostimulation, the combination of pharmacological treatments Solcoseryl™ (SS) and Polygen™ (PG) with light therapy using in-vitro and in-vivo models. In-vitro experiments indicate the ability of laser photons and pharmacological agents SS or PG to augment or abate the cloning efficiency of various cell lines. In-vivo studies focused on the dosimetry of various laser wavelengths and the use of wound healing drugs and 632.8nm laser in wound healing. The application of pharmacological treatments combined with laser therapy reveals the utility of light-drug treatment combinations. Given the ever-increasing cost of medical care, the burden incurred on patients, caregivers and society, this line of research fulfills the increasing need to develop treatment methods that enhance wound healing, especially in situations involving resistance to healing.

Tissue healing is a complex process that involves local and systemic responses. The use of Low Level Laser Therapy (LLLT) for wound healing has been shown to be effective in modulating both local and systemic response. Usually the healing process of bone is slower than that of soft tissues. The effects of LLLT on bone are still controversial as previous reports show different results. This paper reports recent observations on the effect of LLLT on bone healing. The amount of newly formed bone after 830nm laser irradiation of surgical wounds created in the femur of rats was evaluated morphometricaly. Forty Wistar rats were divided into four groups: group A (12 sessions, 4.8J/cm2 per session, 28 days); group C (three sessions, 4.8J/cm2 per session, seven days). Groups B and D acted as non-irradiated controls. Forty eight hours after the surgery, the defects of the laser groups were irradiated transcutaneously with a CW 40mW 830nm diode laser, (f∼1mm) with a total dose of 4.8J/cm2. Irradiation was performed three times a week. Computerized morphometry showed a statistically significant difference between the areas of mineralized bone in groups C and D (p=0.017). There was no significant difference between groups A and B (28 days) (p=0.383). In a second investigation, we determined the effects of LLLT on bone healing after the insertion of implants. It is known that dental implants need four and six months period for fixation on the maxillae and on the mandible before receiving loading. Ten male and female dogs were divided into two groups of five animals that received the implant. Two animals of each group acted as controls. The animals were sacrificed 45 and 60 days after surgery. The animals were irradiated three times a week for two weeks in a contact mode with a CW 40mW 830nm diode laser, (f ∼1mm) with a total dose per session of 4.8J/cm2 and a dose per point of 1.2J/cm2. The results of the SEM study showed better bone healing after irradiation with the 830nm diode laser. These findings suggest that, under the experimental conditions of the investigation, the use of LLLT at 830nm significantly improves bone healing at early stages. It is concluded that LLLT may increase bone repair at early stages of healing.

Studies on low intensity 904 nm laser therapy in the treatment of musculoskeletal disorders show conflicting results. Yet, on the basis of a systematic review we concluded that 904 nm laser therapy for musculoskeletal disorders seems to be promising, when compared to placebo laser therapy. Quick pain relief and fast functional recovery are reported to be the most prominent claims of laser therapy. This paper presents a rationale of choices regarding the patients and type of treatment when designing a randomized, double blind, clinical trial on 904 nm laser therapy, as well as safeguards concerning optimum dose, constancy of dose and double blinding the actual laser therapy.

It was nearly forty years ago That I first began to know, What the potential of the CO2 laser would be, As a thermal scalpel for surgery. The beam, being water absorbable and infra red, When focused on biological tissue, would not burn but vaporize instead. This was shown to be the case, And appropriate experiments then took place. It was found that one could make an incision With the utmost of precision, Without harming the residual tissue, So that healing was not an issue. It was also soon revealed, That vessels were simultaneously sealed, Making surgery haemostatic, And, through non contact, less traumatic. So, a suitable apparatus was then produced, And the laser in clinical surgery was introduced. One then found again and again, The vast reduction in post operative pain. And, since blood and lymphatic vessels are occluded, Surgery through infected tissue is not excluded. With a focused beam one can incise, And, with a defocused one vaporize. After a time, it received an outstanding reception, And is now used in every surgical field without exception. But it's universal acceptance as a surgical knife, Resulted in less and less publications coming to life. So that, only when a specific application was noted, Articles, and papers at congresses, to it, were devoted. Good examples of this are the treatment of wrinkles and snoring, So much having been said about them as to become absolutely boring. All sorts of gadgets were then introduced, Claiming that with them, operative risk was reduced. And on their use people then insisted, So that surgical skill no longer existed. To those who happened to be trained by me, How to use the laser like a scalpel, I tried to make them see. And, I wish to appeal to those of you Who happen to be teachers, to do so too, Because, a good surgeon should develop a good technique, And not rely on gadgets like a freak. And finally, my friends, if sanctimonious I appear, Put it down to my age, and with me try to bear. November 2011

11th Japan Association for Laser Medicine and Sports Science was held in Suwa, Nagano, Japan on Oct. 6th, 2007. The Congress was successful with fruitful papers and lectures.Since Laser Therapy was decided to JALMSS, I contribute Minutes of the 11th Executive Committee Meeting.