We produced experimental inflammation models in rats by carrageenin and studied the effect of Ga-Al-As diode laser irradiation (780 nm, continuous wave, 31.8 j/sec/cm2, spot size of 0.2 mm) on inflamed regions compared with those of indomethacin, a potent anti-inflammatory agent. We found that a low-power infrared laser has an anti-inflammatory effect on carrageenin inflammation. A low-power laser inhibits: (1) the increase of vascular permeability during the occurrence of an acute inflammation in the carrageenin-air-pouch model, (2) edema in the acute stage in the carrageenin-paw-edema model, and (3) the granuloma formation in the carrageenin-granuloma model after receiving laser irradiation once daily. In all cases, irradiation for less than 10 min was sufficient to inhibit the inflammation by 20-30%. The inhibitory effect of laser irradiation was not comparable to that of indomethacin (4 mg/kg, i.o.) in the air-pouch model and the paw-edema model, whereas laser irradiation was more potent than that of daily administration of indomethacin (1 mg/kg, i.o.) in the granuloma model. In future studies of the mechanism of laser effect, it should be noted that irradiating a rat twice, before and after the provocation of inflammation, was essential in order to achieve an effective inhibition of paw-edema.

This study concerned the effect of Ga-Al-As diode laser irradiation (780 nm, continuous wave, 31.8 J/s/cm2, spot size od 0.2 mm, 3 minutes/dose) on hyperalgesia induced in the hind paw of rats by injecting carrageenin. The pressure-pain thresholds of hind paws were measured by the Randall-Selitto test for evaluation of hyperalgesia. Two doses of laser irradiation, given to the inflamed region immediately before and after the injection of carrageenin, partially (approximately 50%) inhibited the occurrence of hyperalgesia accompanied with a progression of inflammation. This analgesic effect was equal to that of indomethacin (4 mg/kg, i.o.). In another group, the hyperalgesia was removed almost completely for at least 24 hours by one dose of laser irradiation, which was given 3 hours after the carrageenin injection, whereas the edema was not inhibited. This analgesic effect, however, was partially (approximately 50%) antagonized with a dose of 10 mg/kg (i.p.) of naloxone and totally inhibited with 30 mg/kg. These results suggest that low-power laser irradiation on inflamed regions of carrageenin-treated rats has a marked analgesic effect and that certain mechanisms that are not related to endogenous opioids are involved in a part of the mechanisms of the analgesic effects.

This study assessed the efficacy and safety of ketoprofen patch compared with placebo in patients who had rheumatoid arthritis and persistent wrist pain. Patients (N = 676)who had achieved systemic disease control with a disease-modifying antirheumatic drug and/or systemic corticosteroid, but still had persistent wrist pain, were randomized to a 2-week course of once-daily treatment with application of a 20-mg ketoprofen patch or a placebo patch to the wrist. The primary efficacy end point was the percent change from baseline to the end of treatment in the intensity of wrist pain scored by each patient on a 100-mm visual analog scale. The mean ± SD percent change on the pain intensity scale was significantly larger in patients treated with ketoprofen than in those receiving placebo (31.2% ± 30.3% [95% confidence interval: 28.0-34.4] vs 25.5% ± 31.2% [95% confidence interval: 22.1-28.8]; P = .020). However, the actual difference of the mean pain intensity scale between the 2 groups was small at the end of treatment. The frequency of adverse events was similar in both groups. The ketoprofen patch was more effective than placebo for relieving persistent local joint pain in patients with rheumatoid arthritis. The patch was also safe and well tolerated during the 2-week treatment period.

We report a patient in whom direct puncture of the superior ophthalmic vein for a cavernous sinus dural arteriovenous fistula led to rapidly progressing thrombosis and postoperative non-arteritic ischemic optic neuropathy (NA-ION), and review the pathogenesis. Case Presentation: A 74-year-old female. Detailed examination of diplopia and visual disorder suggested a cavernous sinus dural arteriovenous fistula. As approaching via a posterior route was difficult, transvenous embolization by direct puncture of the superior ophthalmic vein was performed. As drainage routes were aggregated around this vein, thrombosis of this vein occurred, inducing postoperative NA-ION through a rapid change in hemodynamics. Conclusion: When performing direct puncture of the superior ophthalmic vein, puncture methods and heparinization should be considered after sufficiently investigating drainage routes. Keywords▶ cavernous sinus dural arteriovenous fistula, superior ocular vein direct puncture, ischemic optic neuropathy, thrombosis

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