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Y.-Y. Huang and others TABLE 2. Parameters involved in determining the LLLT “dose” IRRADIATION TIME OR ENERGY DELIVERED (The Dose) Irradiation Unit of Parameter measurement Comment Energy (Joules) Energy Density Irradiation Time Treatment interval J J/cm2 s Hours, days or weeks Calculated as: Energy (J) = Power (W) x time (s) This mixes medicine and dose into a single expression and ignores Irradiance. Using Joules as an expression of dose is potentially unreliable as it assumes reciprocity (the inverse relationship between power and time). Common expression of LLLT “dose” is Energy Density This expression of dose again mixes medicine and dose into a single expression and is potentially unreliable as it assumes a reciprocity relationship between irradiance and time. In our view the safest way to record and prescribe LLLT is to define the four parameters of the medicine (see table 1.) and then define the irradiation time as “dose”. The effects of different treatment interval is underexplored at this time though there is sufficient evidence to suggest that this is an important parameter. laser radiation listed in the “medicine” table; however there is evidence to show that different wavelengths, pulses, coherence, polarization have some effect on the magnitude of biomodulation (see sections 3 and 4). 2. MECHANISMS OF LOW LEVEL LIGHT THERAPY. 2.1. Cellular Chromophores and First Law of Photobiology The first law of photobiology states that for low power visible light to have any effect on a living biological system, the photons must be absorbed by electronic absorption bands belonging to some molecular photoacceptors, or chromophores (Sutherland 2002). A chromophore is a molecule (or part of a molecule) which imparts some decided color to the compound of which it is an ingredient. Chromophores almost always occur in one of two forms: conjugated pi electron systems and metal com- plexes. Examples of such chromophores can be seen in chlorophyll (used by plants for photosynthesis), hemoglobin, cytochrome c oxidase (Cox), myoglobin, flavins, flavoproteins and porphyrins (Karu 1999). Figure 1 illustrates the general concept of LLLT. 2.2. Action Spectrum and Tissue Optics One important consideration should involve the optical properties of tissue. There is a so-called “optical window” in tissue, where the effectivePDF Image | BIPHASIC DOSE RESPONSE IN LOW LEVEL LIGHT THERAPY
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