Treating infections with ionizing radiation: a historical perspective and emerging techniques.

BACKGROUND: Widespread use and misuse of antibiotics have led to a dramatic increase in the emergence of antibiotic resistant bacteria, while the discovery and development of new antibiotics is declining. This has made certain implant-associated infections such as periprosthetic joint infections, where a biofilm is formed, very difficult to treat. Alternative treatment modalities are needed to treat these types of infections in the future. One candidate that has been used extensively in the past, is the use of ionizing radiation. This review aims to provide a historical overview and future perspective of radiation therapy in infectious diseases with a focus on orthopedic infections. METHODS: A systematic search strategy was designed to select studies that used radiation as treatment for bacterial or fungal infections. A total of 216 potentially relevant full-text publications were independently reviewed, of which 182 focused on external radiation and 34 on internal radiation. Due to the large number of studies, several topics were chosen. The main advantages, disadvantages, limitations, and implications of radiation treatment for infections were discussed. RESULTS: In the pre-antibiotic era, high mortality rates were seen in different infections such as pneumonia, gas gangrene and otitis media. In some cases, external radiation therapy decreased the mortality significantly but long-term follow-up of the patients was often not performed so long term radiation effects, as well as potential increased risk of malignancies could not be investigated. Internal radiation using alpha and beta emitting radionuclides show great promise in treating fungal and bacterial infections when combined with selective targeting through antibodies, thus minimizing possible collateral damage to healthy tissue. CONCLUSION: The novel prospects of radiation treatment strategies against planktonic and biofilm-related microbial infections seem feasible and are worth investigating further. However, potential risks involving radiation treatment must be considered in each individual patient.

Antibiotics versus biofilm: an emerging battleground in microbial communities.

Biofilm is a complex structure of microbiome having different bacterial colonies or single type of cells in a group; adhere to the surface. These cells are embedded in extracellular polymeric substances, a matrix which is generally composed of eDNA, proteins and polysaccharides, showed high resistance to antibiotics. It is one of the major causes of infection persistence especially in nosocomial settings through indwelling devices. Quorum sensing plays an important role in regulating the biofilm formation. There are many approaches being used to control infections by suppressing its formation but CRISPR-CAS (gene editing technique) and photo dynamic therapy (PDT) are proposed to be used as therapeutic approaches to subside bacterial biofim infections, especially caused by deadly drug resistant bad bugs.

Radioimmunotherapy as a Novel Approach in HIV, Bacterial, and Fungal Infectious Diseases.

In the past several decades, many antimicrobial agents have been used in treating different fungal, bacterial, and viral infections. However, these agents have faced challenges such as pronounced side-effect profiles and pathogen resistance. In addition, a cure for many chronic infections such as human immunodeficiency virus (HIV) has not been achieved, and the incidence of opportunistic infections in immunocompromised patients has increased significantly in the past decades. Therefore, an alternative strategy for combating these infections is needed. Radioimmunotherapy (RIT) has been proposed to be a valuable tool in the management of such infections. The side-effects associated with RIT are minimal as the targeted antigens are only expressed on microbial or infected cells. RIT demonstrated impressive potency in eradicating pathogens in animal models and patient samples. Cryptococcus neoformans, HIV, and Bacillus anthracis are few examples of infections for which RIT has been an effective treatment using radionuclides such as bismuth-213 (213Bi) or rhenium-188 (188Re).

[The treatment of the patients suffering from acute bacterial external otitis with the use of intravenous blood illumination by low-intensity laser radiation at a wavelength of 445 nm]. / Lechenie bol'nykh ostrym bakterial'nym naruzhnym otitom s primeneniem vnutrivennogo osvechivaniia krovi nizkointensivnym lazernym izlucheniem s dlinoi volny 445 nm.

BACKGROUND: The prevalence of allergic reactions to the pharmaceutical products and the development of antibiotic resistance limit the provision of the high-quality medical care to the patients presenting with acute bacterial external otitis media (ABEO). AIM: The objective of the present study was to evaluate the effectiveness of the treatment of the patients suffering from ABEO with the application of the new technique based on intravenous blood illumination by low-intensity laser radiation at a wavelength of 445 nm (ILBI-445). MATERIAL AND METHODS: This open comparative clinical study was carried out from April 2017 till June 2017 and included the patients with ABEO who were divided into two groups. The patients of the main group underwent the standard treatment in the combination with low-intensity laser radiation at a wavelength of 445 nm. Those comprising the control group were given the conventional treatment alone. The end point of the study was the complete disappearance of local inflammatory signs in the region of the external auditory canal (EAC) and auricle, the restoration of the volume of the EAC, the absence of complaints estimated based on the visual analogue scale (VAS), and the complete disappearance of symptoms of intoxication. The local signs of inflammation in the region of the EAC and auricle were assessed from the otoscopic picture. The measurement of the volume of the external auditory canal were carried out by filling it with a furacilin solution at a temperature of 360C using a 2 ml syringe. The character of the inflammatory changes in the external auditory canal, the intensity of pain and itching, as well as the degree of hearing loss were estimated at 10 points based on the 10-point visual analogue scale (with 0 points standing for the absence of complaints and 10 points denoting the maximum severity of the complaints). The symptoms of intoxication were determined from the measurements of body temperature. RESULTS: The combined treatment of the patients with ABEO using ILBI-445 resulted in their earlier recovery in comparison with that achieved by means of the standard therapy. The differences were especially pronounced on the 5th day of treatment. Complaints of pain and the loss of hearing were documented only in the patients of the control group. Itching was a significantly less serious trouble in the patients of the main group than it was in those comprising the control group. The volume of the external auditory canal in the patients of the main group on the 5th day after the onset of the treatment was more than 16.7% greater than in the control one. CONCLUSIONS: The high therapeutic effectiveness and simplicity of the approach employed in the present study taken together with a minimum of contraindications for its application give reason to recommend intravenous blood illumination by low-intensity laser radiation at a wavelength of 445 nm for the treatment of the patients suffering from acute bacterial external otitis.

Impacts on the third line of defense specialized against microbial infection as a result of exposure to gamma-radiation.

To understand the toxicity and the potential role of gamma-radiation (GR) as a therapeutic tool, the effects of different GR doses on haematological and dimensional properties of rats' blood were investigated in vivo. 60 healthy male Wistar-Kyoto rats were used in this study, and were randomly divided into 5 groups, 4 GR rat groups (1st group was radiated with 5 R, 2nd group 25 Gy; 3rd group with 50 Gy, 4th group with 100 Gy and 5th group was the control). Different haematological and dimensional parameters were measured using the standard haematological technique for complete blood count (CBC). A significant decrease in white blood cells (WBCs) count and lymphocytes (LYM) was observed compared with the control. While a significant increase in monocytes (MON), neutrophils (NEU), basophils (BAS), and eosinophils (EOS) were observed. A non-significant decrease in platelets (PLTs) count was observed with GR compared with the control.

Preclinical testing of radiopharmaceuticals for novel applications in HIV, bacterial and fungal infectious diseases.

Antibiotics, antifungal and antiviral medications have traditionally been used in the management of infections. Due to widespread emergence of resistance to antimicrobial medications, and their side effects, there is a growing need for alternative approaches for management of such conditions. Antibiotic resistant bacterial pathogens are on the rise. A cure has not been achieved for viral infections like AIDS, while fungal and parasitic infections are constant threats to the health of general public. The incidence of opportunistic infections in immunocompromised individuals like HIV patients, patients receiving high dose steroids, chemotherapy patients, and organ transplant recipients is on the rise. Radioimmunotherapy (RIT) has the potential to be a suitable and viable therapeutic modality in the arena of infection management. Provided the target-associated antigen is expressed by the target cells and minimally or not expressed by other tissues, selective targeting of radiation to target sites can be theoretically accomplished with relative sparing normal tissues from radiation exposure. In our laboratory we successfully demonstrated the effectiveness of RIT for treating infectious diseases. We targeted murine cryptococcosis with a mAb to the Cryptococcus neoformans capsular glucuronoxylomannan labeled with Bismuth-213 ((213)Bi) or Rhenium-188 ((188)Re). We subsequently extended the applicability of RIT for treating bacterial and viral infections. One of the advantages of using RIT to treat infections as opposed to cancer is that, in contrast to tumor cells, cells expressing microbial antigens are antigenically very different from host tissues and thus provide the potential for exquisite specificity and low cross-reactivity. Ever increasing incidence of infectious pathologies, exhaustion of antimicrobial possibilities and rising drug resistance calls for use of alternative and novel therapeutic options and we believe RIT is the need of the hour to combat these infections.

Periodontal and peri-implant wound healing following laser therapy.

Laser irradiation has numerous favorable characteristics, such as ablation or vaporization, hemostasis, biostimulation (photobiomodulation) and microbial inhibition and destruction, which induce various beneficial therapeutic effects and biological responses. Therefore, the use of lasers is considered effective and suitable for treating a variety of inflammatory and infectious oral conditions. The CO2 , neodymium-doped yttrium-aluminium-garnet (Nd:YAG) and diode lasers have mainly been used for periodontal soft-tissue management. With development of the erbium-doped yttrium-aluminium-garnet (Er:YAG) and erbium, chromium-doped yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers, which can be applied not only on soft tissues but also on dental hard tissues, the application of lasers dramatically expanded from periodontal soft-tissue management to hard-tissue treatment. Currently, various periodontal tissues (such as gingiva, tooth roots and bone tissue), as well as titanium implant surfaces, can be treated with lasers, and a variety of dental laser systems are being employed for the management of periodontal and peri-implant diseases. In periodontics, mechanical therapy has conventionally been the mainstream of treatment; however, complete bacterial eradication and/or optimal wound healing may not be necessarily achieved with conventional mechanical therapy alone. Consequently, in addition to chemotherapy consisting of antibiotics and anti-inflammatory agents, phototherapy using lasers and light-emitting diodes has been gradually integrated with mechanical therapy to enhance subsequent wound healing by achieving thorough debridement, decontamination and tissue stimulation. With increasing evidence of benefits, therapies with low- and high-level lasers play an important role in wound healing/tissue regeneration in the treatment of periodontal and peri-implant diseases. This article discusses the outcomes of laser therapy in soft-tissue management, periodontal nonsurgical and surgical treatment, osseous surgery and peri-implant treatment, focusing on postoperative wound healing of periodontal and peri-implant tissues, based on scientific evidence from currently available basic and clinical studies, as well as on case reports.

Photodynamic inactivation of biofilm: taking a lightly colored approach to stubborn infection.

Microbial biofilms are responsible for a variety of microbial infections in different parts of the body, such as urinary tract infections, catheter infections, middle-ear infections, gingivitis, caries, periodontitis, orthopedic implants, and so on. The microbial biofilm cells have properties and gene expression patterns distinct from planktonic cells, including phenotypic variations in enzymic activity, cell wall composition and surface structure, which increase the resistance to antibiotics and other antimicrobial treatments. There is consequently an urgent need for new approaches to attack biofilm-associated microorganisms, and antimicrobial photodynamic therapy (aPDT) may be a promising candidate. aPDT involves the combination of a nontoxic dye and low-intensity visible light which, in the presence of oxygen, produces cytotoxic reactive oxygen species. It has been demonstrated that many biofilms are susceptible to aPDT, particularly in dental disease. This review will focus on aspects of aPDT that are designed to increase efficiency against biofilms modalities to enhance penetration of photosensitizer into biofilm, and a combination of aPDT with biofilm-disrupting agents.

Ultraviolet C irradiation: an alternative antimicrobial approach to localized infections?

This review discusses the potential of ultraviolet C (UVC) irradiation as an alternative approach to current methods used to treat localized infections. It has been reported that multidrug-resistant microorganisms are equally sensitive to UVC irradiation as their wild-type counterparts. With appropriate doses, UVC may selectively inactivate microorganisms while preserving viability of mammalian cells and, moreover, is reported to promote wound healing. UVC is also found in animal studies to be less damaging to tissue than UVB. Even though UVC may produce DNA damage in mammalian cells, it can be rapidly repaired by DNA repair enzymes. If UVC irradiation is repeated excessively, resistance of microorganisms to UVC inactivation may develop. In summary, UVC should be investigated as an alternative approach to current methods used to treat localized infections, especially those caused by multidrug-resistant microorganisms. UVC should be used in a manner such that the side effects would be minimized and resistance of microorganisms to UVC would be avoided.

Laser phototherapy in the treatment of periodontal disease. A review.

Many studies in the literature address the effect of low-power lasers in the management of pathologies related to periodontal tissues. Due to the lack of standardized information and the absence of a consensus, this review presents the current status of laser phototherapy (LPT) in periodontics and discusses its benefits and limits in the treatment of periodontal disease. The literature was searched for reviews and original research articles relating to LPT and periodontal disease. The articles were selected using either electronic search engines or manual tracing of the references cited in key papers. The literature search retrieved references on wound and bone healing, analgesia, hypersensitivity, inflammatory process and antimicrobial photodynamic therapy. Each topic is individually addressed in this review. The current literature suggests that LPT is effective in modulating different periodontal disease aspects in vitro, in animals, and in simple clinical models. Further development of this therapy is now dependent on new clinical trials with more complex study designs.

High power accelerator-based boron neutron capture with a liquid lithium target and new applications to treatment of infectious diseases.

A new conceptual design for an accelerator-based boron neutron capture therapy (ABNCT) facility based on the high-current low-energy proton beam driven by the linear accelerator at SARAF (Soreq Applied Research Accelerator Facility) incident on a windowless forced-flow liquid-lithium target, is described. The liquid-lithium target, currently in construction at Soreq NRC, will produce a neutron field suitable for the BNCT treatment of deep-seated tumor tissues, through the reaction (7)Li(p,n)(7)Be. The liquid-lithium target is designed to overcome the major problem of solid lithium targets, namely to sustain and dissipate the power deposited by the high-intensity proton beam. Together with diseases conventionally targeted by BNCT, we propose to study the application of our setup to a novel approach in treatment of diseases associated with bacterial infections and biofilms, e.g. inflammations on implants and prosthetic devices, cystic fibrosis, infectious kidney stones. Feasibility experiments evaluating the boron neutron capture effectiveness on bacteria annihilation are taking place at the Soreq nuclear reactor.

Utilização da terapia fotodinâmica associada ou não ao hipoclorito de sódio na instrumentação de canais radiculares contaminados com Enterococcus faecalis / The use of photodynamic therapy associated or not to sodium hypochlorite in the instrumentation of radicular canals contaminated by Enterococcus faecalis

O presente trabalho teve por objetivo avaliar a ação do laser de baixa intensidade associado ao corante azul de toluidina, como agente bactericida durante a fase de instrumentação dos canais radiculares, comparando sua utilização associada ou não ao hipoclorito de sódio 0,5%. Para tal, 90 caninos humanos foram instrumentados, autoclavados e 88 imersos em caldo TSB (Tryptcase Soy Broth). Em seguida foram inoculados com suspensão de E. faecalis e incubados em estufa a 37°C, por 72 horas, para permitir a formação do biofilme. As amostras foram randomicamente divididas em 4 grupos de 22 dentes cada e 1 grupo controle negativo com 2 dentes. Grupo I: reinstrumentados e irrigados com soro fisiológico com posterior aplicação de terapia fotodinâmica (PDT); Grupo II: reinstrumentados e irrigados com hipoclorito de sódio a 0,5% com posterior aplicação de PDT; Grupo III: reinstrumentados e irrigados com hipoclorito de sódio a 0,5%; Grupo IV controle positivo: não foi realizado nenhum tipo de tratamento antes da coleta do material e Grupo V controle negativo: não foram contaminados. Para a coleta da dentina intracanal utilizou-se uma broca Gates Glidden número 6. A atividade antimicrobiana foi avaliada por meio da contagem de UFCs (unidades formadoras de colônias). Os dentes foram então imersos em meio seletivo para enterococos, incubados em estufa a 37º C por 72 horas e avaliados quanto à alteração de coloração do meio. Todas as amostras, exceto o controle negativo, apresentaram-se positivas. Com a finalidade de certificar-se da formação do biofilme e da confirmação dos resultados das contagens das UFCs, 9 amostras foram avaliadas ao MEV (microscopia eletrônica de varredura)...

This current paper aims to assess the action of low-intensity laser together with toluidine blue as a bactericidal agent during the instrumentation phase of radicular canals, comparing its associated or non-associated use with sodium hypochlorite 0.5%. To do so, 90 human canines were instrumented, autoclaved, and 88 were immersed into TSB, and were then inoculated with an E. faecalis suspension and brought into an incubator at 37 degrees Celsius for 72 hours in order to allow the formation of biofilm. The samples were randomly divided into 5 groups, 4 of which composed of 22 samples each plus 1 negative control. Group I: reinstrumented and irrigated with saline solution and subsequent application of photodynamic therapy (PDT); Group II: reinstrumented and irrigated with sodium hypochlorite 0.5% and subsequent PDT application; Group III: reinstrumented and irrigated with sodium hypochlorite 0.5%; Group IV: positive control (no previous treatment before material collection); Group V: negative control (2 samples) with no contamination. The collection of intracanal dentin was obtained by using a Gates Glidden drill nr. 6. The antimicrobial activity was assessed by CFUs counting. The teeth were then immersed in a selected medium for Enterococcus, incubated at 37 degrees Celsius for 72 hours. They were then assessed for medium turbidity. All samples, with the exception of the negative control, showed positive. In order to make sure of the formation of biofilm and the confirmation of the CFUs counting, 9 samples were scavenged under the electron microscope...

O efeito do laser de baixa energia no crescimento bacteriano "in vitro" / Low level laser effect in \"in vitro\" bacterial growth

OBJETIVO: Avaliar, por meio de estudo bacteriológico in vitro, o efeito de dois tipos de laser de baixa energia (LBE) sobre diferentes populações bacterianas habitualmente presentes em feridas pós-traumáticas. MÉTODOS: Foram colhidos swabs diretamente do sítio de infecção de pacientes internados com osteomielite pós-traumática crônica. As bactérias isoladas foram Acinetobacter baumanii complex, Escherichia coli, Haemophilus influenzae, Klebsiella pneumoniae, Pseudomonas aeruginosa, Salmonela sp, Serratia sp e Staphylococcus aureus. O material coletado foi semeado em meio ágar-sangue, através de alça estéril, utilizando-se 30 placas de Petri para cada germe. Foram utilizados dois aparelhos de LBE: Ibramed Laser Pulse #01189, com 15W/904nm por 200 segundos, e Phisiolux dual Bioset #9909001, com 20W/904nm por 230 segundos. Nos grupos I (n = 10) e II (n = 10), as bactérias sofreram irradiação pelo laser. O grupo III (n = 10) serviu de controle, não sendo irradiado. As bactérias dos grupos I e II foram irradiadas em câmara de fluxo laminar, previamente esterilizada por raio ultravioleta. O laser foi administrado de forma direta, central e perpendicularmente à superfície de cultivo das bactérias, com distância-padrão de 1cm, através de orifício confeccionado na tampa das placas. O crescimento bacteriano foi analisado após 12 e 24 horas da irradiação. Os resultados foram processados estatisticamente, utilizando-se o teste não-paramétrico de Kruskall-Wallis, com nível de significância p < 5 por cento. RESULTADOS: Observou-se comportamento similar entre as populações bacterianas nos três grupos experimentais após 12 e 24 horas da irradiação com os dois tipos de LBE, não havendo diferença estatisticamente significante no crescimento bacteriano entre os grupos I e II e entre estes e o grupo III (controle). CONCLUSÃO: O efeito do LBE, nas condições estudadas, mostrou-se inócuo quanto ao aumento do número de unidades formadoras de colônias bacterianas,...

OBJECTIVE: To perform an in vitro bacteriologic study to evaluate the effect of two types of low level laser (LLL) on different bacterial populations usually present in post-traumatic wounds. METHODS: Swabs were prepared directly at the infection site of patients hospitalized with chronic post-traumatic osteomyelitis. Isolated bacteria were Acinetobacter baumanii complex, Escherichia coli, Haemophilus influenzae, Klebsiella pneumoniae, Pseudomonas aeruginosa, Salmonela sp, Serratia sp, and Staphylococcus aureus. The material collected was seeded in agar-blood medium with a sterile loop, using 30 Petri dishes for each germ. Two LLL devices were used: Ibramed Laser Pulse #01189, with 15W/904nm for 200 seconds, and Phisiolux dual Bioset #9909001, with 20W/904nm for 230 seconds. In groups I (n = 10) and II (n = 10), bacteria were irradiated with laser. Group III (n = 10) was the control group and was not irradiated. Bacteria in groups I and II were submitted to radiation in a laminar flow chamber that was previously sterilized with UV rays, and the laser was directly, centrally, and perpendicularly applied to the bacteria cultivation surface, from a standard distance of one centimeter, through an orifice made in the lid of the dishes. Bacterial growth was analyzed 12 and 24 hours after the irradiation. Results were statistically processed using the non-parametric test of Kruskall-Wallis, with a significance level p < 5 percent. RESULTS: A similar behavior was seen in the bacterial population of the three groups studied after 12 and 24 hours of irradiation with the two types of LLL, and there was no statistically significant difference in the bacterial growth between groups I and II and between these two groups and group III (control). CONCLUSION: In the conditions of this study, the effect of LLL showed to be innocuous for the increase in the number of units forming bacterial colonies, in the doses used in this study, as an adjuvant for...

[Using AELTIS-synchro-02 device in the therapy of chronic bacterial prostatitis].

The treatment of chronic bacterial prostatitis combined antibacterial drugs and physiotherapy (low-energy laser radiation, electrostimulation of the prostate). Treatment of chronic bacterial prostatitis with medication and complex two-channel bio-synchronized electrolaser therapy with application of the unit AELTIS-synchro-02 raises efficacy of treatment with chronic bacterial prostatitis due to combined effect of antibacterial drugs and bacteriostatic and immunomodulating actions of the physical factors applied. These normalize microcirculation in the region of the prostatic gland, improve a draining function of the prostatic ducts, allows achievement of good results in 88.2% patients.

Treatment of infection with radiolabeled antibodies.

The field of infectious diseases is in urgent need of new approaches to antimicrobial therapy. Radio-immunotherapy (RIT) has evolved into successful therapy for certain malignancies. Published preclinical and clinical investigations have demonstrated that radiolabeled microorganism-specific antibodies localize to tissue sites of bacterial and fungal infection. The potential of RIT as an antimicrobial treatment strategy has not been developed clinically, which could reflect lack of awareness of the difficult problems in clinical infectious diseases by the nuclear medicine community and of RIT by the infectious diseases physicians. We have recently demonstrated the feasibility of using RIT for treating murine cryptococcosis using a monoclonal antibody to Crypto-coccus neoformans capsular glucuronoxylomannan labeled with Bismuth-213 or Rhenium-188. Subsequently, we showed the applicability of RIT to bacterial (Streptococcus pneumonia) and viral (HIV-1) infections. Treatment did not cause acute hematologic toxicity in treated animals. The mechanisms of RIT of infection include killing of microbial cells by ''direct hit'' and ''cross-fire'' effects, promotion of apoptosis-like death, cooperation with macrophages and modulation of the inflammatory response. RIT for infection is theoretically useful for any microbe susceptible to radiation, including bacteria, fungi, viruses and parasites. The promise of this technique is based on the fact that the technology is largely in place and that the only requirements are availability of microbe-specific monoclonal antibodies and suitable radionuclides. In fact, one could anticipate that targeting microbes will be easier than targeting neoplastic cells when the enormous antigenic differences between host and microbes are taken into consideration. However, considerable basic work remains to be done to ascertain the optimal conditions for the efficacy of RIT for infection.

Histologic effects of laser-assisted topical anesthesia in a porcine model.

OBJECTIVES: A handheld laser device that removes the stratum corneum, the major barrier to transdermal absorption, has recently been approved to assist with topical anesthesia before painful procedures such as intravenous cannulation. The authors assessed the cutaneous histomorphologic effects of the laser device and the ability of the laser-treated skin to resist infection in a porcine model. METHODS: This was a blinded, randomized animal experiment using isoflurane-anesthetized young domestic pigs. The ventral surface of the animals was irradiated multiple times with a lightweight, portable erbium yttrium-aluminum-garnet unit or a sham laser. One third of the wounds were inoculated with a Staphylococcus aureus suspension. The treated areas were then covered with a dry dressing, and full-thickness biopsy specimens of the treated areas were obtained immediately after treatment and at three, seven, ten, and 14 days for blinded histopathologic evaluation using hematoxylin and eosin staining and electron microscopy. Quantitative bacterial counts were obtained at three days in wounds exposed to bacteria. Main outcomes were quantitative bacterial counts, presence of cellular necrosis, epidermal integrity, and dermal scarring. Data analysis was conducted with descriptive statistics. RESULTS: Laser irradiation resulted in immediate disruption of the cornified layer of the skin and necrosis of the stratum spinosum in all treated areas. There were also focal areas of vacuolar alteration of the basal one third of the epidermis. There was no evidence of any damage to the basement membrane or the underlying dermis. At three days, the epidermis had healed and there was evidence of epidermal hyperplasia and hyperkeratosis that was completely resolved by 14 days. There were no infections and no scarring. Sham laser had no histomorphologic effects on the skin. There was no bacterial growth from all sham laser-treated wounds challenged with bacteria. Three of 20 (15%; 95% confidence interval = 0% to 31%) laser-irradiated wounds that were challenged with bacteria grew between 280,000 and 1,600,000 colony-forming units/g. CONCLUSIONS: Laser irradiation results in ablation of the stratum corneum and a superficial burn to the epidermis that heals by three to 14 days without any scarring or infection in pigs. Challenging laser-irradiated cutaneous wounds with a large bacterial inoculum resulted in bacterial growth in a minority of wounds.

Oral bacteria in multi-species biofilms can be killed by red light in the presence of toluidine blue.

BACKGROUND AND OBJECTIVES: Oral bacteria can be killed by light in the presence of a suitable photosensitizer, and this could be used in the treatment of oral infections. In these diseases, however, bacteria are present as biofilms, which are refractive to antimicrobial agents. The purpose of this study was to determine whether oral bacterial biofilms were susceptible to lethal photosensitization. STUDY DESIGN/MATERIALS AND METHODS: Multi-species biofilms of oral bacteria were irradiated with light from a helium/neon laser in the presence of toluidine blue O (TBO) and the survivors enumerated. Controls examining the effects of light and TBO alone were also included. The biofilms were also examined by confocal scanning laser microscopy (CSLM). RESULTS: CSLM revealed that the biofilms had structures similar to those of dental plaque. Although, the biofilms consisted of extremely large numbers of bacteria ( approximately 9 x 10(9)), 97.4% were killed following irradiation with 31.5 J of laser light in the presence of 25 microg/ml TBO. CONCLUSIONS: Substantial numbers of oral bacteria in multi-species biofilms can be killed by light in the presence of TBO. This may be useful in the treatment of dental plaque-related diseases.

[A method and the clinico-laboratory results of laser therapy for patients with chronic prostatitis]. / Metodika i kliniko-laboratornye rezul'taty lazernoi terapii bol'nykh khronicheskim prostatitom.

Local exposures to low-intensity laser radiation (LILR) in chronic prostatis (CP) patients diminish basic symptoms of the disease (pain, dysuria, sex disorders, objective picture). Clinical response was obtained in 93.2% of cases. LILR markedly improved prostatic function, promoted trends to normalization of quantitative and biochemical ejaculate composition. LILR may act as antiaggregator contributing to less ejaculate viscosity and stimulate spermatozoal activity and motility. The above results were seen in 72.4-80% of the exposed patients. CP laser therapy should be wider introduced in clinical practice because its resolving, antiedema, anti-inflammatory, analgetic and deaggregation effects potential.

[Phase treatment of suppurative wounds using ultrasonics and laser irradiation in patients with diabetes mellitus]. / Faznoe lechenie gnoinykh ran s ispol'zovaniem ul'trazvuka i lazernogo izlucheniia u bol'nykh sakharnym diabetom.

A result of treatment of 112 patients with diabetes mellitus and purulent surgical diseases has been analysed. In the complex of treatment, a low-frequency ultrasound and laser radiation were employed. An advantage of the use of ultrasound at the first, and laser--at the second phase of a wound process was noted. Phasic use of ultrasound and laser accelerates the course of a wound process, contributes to shortening the duration of treatment.