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Paper text:
superficial thrombophlebitis ( st ) refers to an inflammatory alteration or infection in the 
 wall of the superficial vein and is characterized by a progressive blood clot formation .
the 
 symptoms of st are severe pain , skin erythema , hot flush , local edema , thickening , and 
 painful tendon cords along the invaded vein1 , 2 . the main cause of st is intubation of the 
 vein1 , vasospasm and pain are induced by 
 anti - cancer agents3 . injection of 
 anti - cancer agents through an intravenous lock results in blood vascular side effects , 
 including thrombophlebitis4 .
regarding the 
 treatment for st , medicinal therapy is chiefly used , whereas mild exercise , such as walking , 
 is recommended . for alleviation of pain and symptoms , hot packs and compression using a 
 bandage or stocking
because low - level laser therapy ( lllt ) has stimulating effects on the body , it is effective 
 for the stimulation of blood circulation , for the expansion of blood vessels , as an 
 inflammatory reaction therapy , scar healing5 , 6 , and for pain reduction in inflammatory 
 diseases7 , 8 . although no previous studies have been explored the effects of 
 physiotherapy on st , lllt has been proved effective for the treatment of inflammatory 
 diseases that are similar to st . here ,
we report the effects of lllt on st after injection 
 of an anti - cancer in a patient with breast cancer .
a 66-year - old woman underwent right mastectomy at h hospital on july 29 , 2014 .
she 
 developed st after chemotherapy ( ctx ) was performed on the left accessory cephalic vein in 
 september 2014 .
the 
 study was performed in accordance with the ethical principles of the declaration of 
 helsinki .
the level of 
 pain , scar tissue , and circumference of the scar tissue were evaluated ; furthermore , a 
 bioimpedence analysis ( bia ) of the st site was performed .
pain was assessed using the visual 
 analog scale ( vas ) , and the pain score was 8 .
the scar tissue was assessed using the patient 
 and observer scar assessment scale ( posas ) , and a score of 51 was obtained for the observer 
 portion and a score of 48 was obtained for the patient portion .
the circumference 
 measurements were obtained using a tapeline ; axillary , 10  cm above the elbow , at the elbow , 
 10  cm below the elbow , at the wrist , and at the palm9 .
the measurements at the above mentioned sites were 27 , 24 , 21 , 18 , 
 14.5 and 18  cm , respectively , in the left upper limb , and 21  cm at the center of the st 
 site .
regarding the bia , the amount of moisture and moisture percentage were measured using 
 inbody s10 ( biospace , seoul , korea ) .
the amount of moisture was 1,090  ml and the moisture 
 percentage was 0.384% in the left upper limb .
the patient received lllt twice during the 
 hospitalization ( january 27 and 28 ) .
lllt enabled vertical examination of the st spot by 
 using super lizer ha-2200 ( tokyo iken , tokyo , japan ) for 10  min .
super lizer ha-2200 is the 
 first linearly polarized light therapeutic equipment with a wavelength range of 
 6001,600  nm . because the patient was repeatedly hospitalized and discharged because of ctx , 
 therapy was implemented for 6 times in total , including therapy performed on february 17 ( 1 
 time ) and on march 911 , 2015 ( 3 times ) .
a reevaluation was performed on february 17 , 2015 , 
 and the vas score was found to be 4 , whereas the posas score for the observer portion was 44 
 and that for the patient portion was 38 for the scar tissue .
the circumference measurements 
 were 27 , 24 , 21.5 , 19 , 15 , and 18  cm , for the respective sites mentioned above , in the left 
 upper limb , and 21  cm at the st site .
the bia showed that the amount of moisture was 
 1,130  ml and the moisture percentage was 0.383% in the left upper limb . in a reevaluation 
 performed on march 9 , 2015 ,
the vas was 0 , whereas the pasos score for the observer portion 
 was 35 and that for the patient portion was 22 for the scar tissue .
the circumference 
 measurements were 27 , 24 , 21.5 , 20 , 15 , and 18  cm , for the respective sites mentioned above , 
 in the left upper limb , and 21  cm at the st site .
the bia showed that the amount of moisture 
 was 1,010  ml and the moisture percentage was 0.393% in the left upper limb .
according to the results of the reevaluation on june 10 , 2015 , the pain vas score decreased 
 to 0 , the posas score of the scar tissue decreased to 33 points for the observer portion and 
 to 22 points for the patient portion .
the circumference measurements for the respective 
 sites mentioned above were 27 , 23 , 21 , 19 , 14.5 , and 17.5  cm in the left upper limb , and 
 21  cm at the st site .
the bia showed that the amount of moisture was 1,070  ml and the 
 moisture percentage was 0.385% in the left upper limb , indicating no significant difference 
 between the results of the last reevaluation and those of the reevaluation on june 10 .
we examined the effects of lllt on st in a breast cancer patient after therapy with an 
 anti - cancer agent .
lllt decreased the pain scoreby8 points ; the observer portion of the 
 posas , by 18 points in the scar tissue ; and the patient portion of the posas , by26 in the 
 scar tissue .
in particular , the effects of lllt on the level of pain and scar 
 tissue persisted up to the follow - up evaluation on june 10 . considering that no difference 
 was observed in the circumference measurements and in the results of bia among the 
 reevaluations , st was thought not have an impact on edema .
no direct previous studies have explored the effects of lllt on st . however , on examination 
 of the previous literature on the effects of lllt on inflammatory disease , we found a report 
 by jastifer et al.7 that showed pain 
 reduction after application of lllt to patients with plantar fasciitis . furthermore , 
 eslamian et al.8 reported significant pain 
 reduction , with the vas score decreasing from 7.28 ( 010 ) to 3.12 after implementation of 
 traditional physiotherapy and lllt for patients with rotator cuff tendinitis . in this study
, 
 lllt also reduced the level of pain although our patient presented with a different 
 inflammatory disease , i.e. , st . moreover
, although no researcher has explored the effects of 
 lllt on scar tissue due to st , dirican et al.10 examined the impact of lllt on the scar tissues of patients with 
 breast cancer and showed that the of posas scores decreased in 76.4% of the research 
 subjects . moreover , lllt has been thought to have similar effects on scar tissue due to st . 
 although a clear mechanism is not clarified yet , factors such as mitochondria activation , 
 adenosine triphosphate synthesis , protein synthesis stimulation , ph control inside and 
 outside of a cell , and cell metabolism activation11 could have affected the results . here , we report the individual therapy results of a single st patient . because this study 
 included only 1case without a control group ,
the correlation between lllt therapy and st was 
 not clearly investigated . moreover , even though the scar tissue in st was evaluated using 
 posas , the evaluation method is not yet standardized . in the current situation ,
where 
 specific research on physiotherapy for patients with st is scarce , we experienced that lllt 
 was helpful for the reduction of pain and scar tissue .
confirmation of the sustained effects 
 of lllt on st in a follow - up 5 months after the patient s first examination was particularly 
 meaningful . although the present study included only 1 case ,
we believe that it will open 
 the doors for future large - scale studies on this topic ; moreover , this study yielded 
 positive research results .
[ purpose ] we report the case of a breast cancer patient with superficial thrombophlebitis 
 treated with low - level laser therapy . [ case ] the patient was a 66-year - old women who 
 developed superficial thrombophlebitis in the left upper limb after chemotherapy . 
 she was 
 administered 6 sessions of low - level laser therapy . 
 [ result ] her pain score decreased by 8 
 points . her scores on the patient and observer scar assessment scale decreased by 18 
 points for the observer portion and by 26 points for the patient portion . 
 [ conclusion ] 
 low - level laser therapy is effective for the reduction of pain and the size of scar tissue 
 in patients with superficial thrombophlebitis .