Takac S, Stojanović S
Zavod za sudsku medicinu, Medicinski fakultet, Novi Sad.
Med Pregl. 1998 May-Jun;51(5-6):245-9.
In this brief report authors present data regarding the application of diagnostic and biostimulating laser instruments in medicine. For diagnostic purposes there are several types of laser instruments and procedures available: Laser Microscopic Masonic Analyzer (LAMMA), Flow cytometry. Doppler effects of laser rays (Laser Doppler velocytometry, Laser Doppler spermokhinezymetry, Laser Doppler spectrometry), Laser fluorescent microscopy, Laser nephelometry, Transilumination by lasers (diaphanography), Laser spectroscopy, Laser holography, Laser rethinoscopy, Microirradiation by lasers. Literary data concerning favorable effects of low power laser radiation on series of diseases covering different medical specialties are cited, pointing to possibility of significant enrichment of already available arsenal of physical methods, thera-pies and rehabilitation procedures. Mechanisms of biostimulation of human tissues and organs under low power laser radiation are also presented. All these stimulatory and regulatory mechanisms of the cell metabolism are involved in the wound epitelization, reduction of edema and inflammation and reestablishement of arterial, venous and lymph microcirculation and consequently inducing better tissue nutrition. The use of laser spectroscopy for quantitative analysis of cations from a single drop of dried blood on a piece of filter paper was not realized, although individual analyses of frozen skin biopsies for calcium, arsenic and gold were accomplished. In Europe, this technique has also found its application in forensic medicine. Furthermore, laser-based methods have been used to study air pollution with carcinogens in occupational exposures and also for the detection of narcotic drugs. Laser cytofluorometry utilizes the argon laser for scanning of single stained cells and has achieved utilization in mass examination programs for Pap-smear determinations. The same technique is used in cell sorting system that is now important in monoclonal antibody determination in hybridoma technology. Other possible diagnostic applications include laser particle size measurement techniques, and laser nephelometry for determination of immunoglobulins classes and autoantibodies such as rheumatoid factors. Laser Doppler velocimetry is used to measure blood flow by means of a simple probe that rests on the lip. Biostumulating laser instruments The world famous Hungarian scientist Mester Endre, from Budapest, is one of the pioneers with the greatest experimental and clinical experience in the use of biostimulating effects of lasers. His former student, O. Ribari first used biostimulating effects of He-Na laser (390 mJ power) for the epitelization of perforated tympanic membrane and treatment of postoperative fistulas of the neck and of the mastoid. Generally speaking, biostimulating effect of low level laser treatment (LLLT) is in its anti-inflammatory, analgesic and anti-edematous effect on tissues. There is absolute increase in microcirculation, higher rates of ATP, RNA and DNA synthesis, and thus better tissue oxygenation and nutrition. There is also increase in the absorption of interstitial fluid, better tissue regeneration and stimulation of the analgesic effect. The past three decades of laser medicine and surgery have shown great progress and promise for the future.
在本简要报告中,作者介绍了诊断和生物刺激激光仪器在医学中的应用数据。出于诊断目的,有几种类型的激光仪器和程序可供使用:激光显微镜共济会分析仪(LAMMA)、流式细胞术。激光束的多普勒效应(激光多普勒测速法、激光多普勒精子激酶法、激光多普勒光谱法)、激光荧光显微镜、激光比浊法、激光透照法(透照造影)、激光光谱学、激光全息术、激光视网膜镜检查、激光微照射。文中引用了有关低功率激光辐射对涵盖不同医学专业的一系列疾病的有益影响的文献数据,指出了显著丰富现有物理方法、治疗方法和康复程序的可能性。还介绍了低功率激光辐射下人体组织和器官的生物刺激机制。细胞代谢的所有这些刺激和调节机制都参与伤口上皮化、减轻水肿和炎症以及重建动脉、静脉和淋巴微循环,从而改善组织营养。虽然完成了对冷冻皮肤活检样本中钙、砷和金的个别分析,但未实现使用激光光谱法对滤纸上一滴干血中的阳离子进行定量分析。在欧洲,这项技术也已在法医学中得到应用。此外,基于激光的方法已被用于研究职业暴露中致癌物的空气污染,也用于检测麻醉药品。激光细胞荧光测定法利用氩激光扫描单个染色细胞,并已在巴氏涂片检测的大规模检查项目中得到应用。同样的技术用于细胞分选系统,该系统在杂交瘤技术的单克隆抗体测定中现在很重要。其他可能的诊断应用包括激光粒度测量技术,以及用于测定免疫球蛋白类别和类风湿因子等自身抗体的激光比浊法。激光多普勒测速法用于通过放置在嘴唇上的简单探头测量血流。生物刺激激光仪器 来自布达佩斯的世界著名匈牙利科学家梅斯特·恩德雷是在利用激光的生物刺激效应方面具有最丰富实验和临床经验 的先驱之一。他的前学生O. 里巴里首次将氦 - 氖激光(功率390 mJ)的生物刺激效应用于穿孔鼓膜的上皮化以及颈部和乳突术后瘘管 的治疗。一般来说,低强度激光治疗(LLLT)的生物刺激作用在于其对组织的抗炎、镇痛和抗水肿作用。微循环有绝对增加,ATP、RNA和DNA合成率更高,从而改善组织氧合和营养。间质液的吸收也增加,组织再生更好,镇痛作用得到刺激。过去三十年的激光医学和外科手术已显示出巨大进展并对未来充满希望。