Low-level laser therapy/treatment (LLLT) using a minimally invasive laser needle system (MILNS) might enhance bone formation and suppress bone resorption. In this study, the use of 405 nm LLLT led to decreases in bone volume and bone mineral density (BMD) of tibial trabecular bone in wild-type (WT) and Per2 knockout (KO) mice. Bone volume and bone mineral density of tibial trabecular bone was decreased by 405 nm LLLT in Per2 KO compared to WT mice at two and four weeks. To determine the reduction in tibial bone, mRNA expressions of alkaline phosphatase (ALP) and Per2 were investigated at four weeks after 405 nm laser stimulation using MILNS. ALP gene expression was significantly reduced in the LLLT-stimulated right tibial bone of WT and Per2 KO mice compared to the non-irradiated left tibia (p < 0.001). Per2 mRNA expression in WT mice was significantly reduced in the LLLT-stimulated right tibial bone compared to the non-irradiated left tibia (p < 0.001). To identify the decrease in tibial bone mediated by the Per2 gene, levels of runt-related transcription factor 2 (Runx2) and ALP mRNAs were determined in non-irradiated WT and Per2 KO mice. These results demonstrated significant downregulation of Runx2 and ALP mRNA levels in Per2 KO mice (p < 0.001). Therefore, the reduction in tibial trabecular bone resulting from 405 nm LLLT using MILNS might be associated with Per2 gene expression.

The meningiomas are slowly growing tumors arising from meningoepithelial cells and they generally occur throughout the craniospinal axis. Meningiomas extending to the middle ear cavity are uncommom and these patients complain of otologic symptoms such as hearing loss, ear fullness, or otorrhea. Clinical findings frequently suggest otitis media resistant to conventional treatments, thereby facilitating misdiagnosis. CT and MRI of the temporal bone are essential and important for the radiologic differential diagnosis with other tumors. The ideal treatment of these tumors is a total surgical removal. In this report, we describe 2 cases of middle ear meningioma originating from middle and posterior cranial fossas with a review of the literatures.