The paper summarizes results of multi-year author’s researches devoted to the mechanisms of interaction between high- and low-level laser light and biological tissues. For the first time in the world literature (1969) the author described the aseptic productive nature of inflammation; a leading role of cellular elements of the mononuclear phagocyte (macrophage) system in the reparative process was shown. These findings morphologically backgrounded the widespread application of lasers in various fields of medicine.

Effects of low-level laser light at the healing process in skin wounds as well as interaction of Ethibond threads with wound tissues have been studied in this work. Linear wounds were made on the back of white rats. To assess changes in wounds and interaction of Ethibond threads with wound tissues, the researchers used morphologic approaches; to assess changes in wound microcirculation, laser Doppler flowmetry was used. The ratio of various erythrocyte forms in wounds was studied as well. It has been shown that laser irradiation reduces inflammatory changes in tissues when contacting with Ethibond threads, normalizes the ratio of normal and pathologic erythrocytes, intensifies microcirculation what ultimately leads to the acceleration of wound healing process.

The article presents findings obtained in patients with inoperable cancer tumors of different departments of extrahepatic bile ducts and the large duodenal papilla after they had been treated with photodynamic therapy. The applied technique is described; different options of laser light delivery to different segments of the biliary tract are discussed. After the statistical processing, the researchers could define PDT reasonability, efficiency and frequency of repeated sessions. There were 28 patients: 8 men (32.1%) and 19 women (67.9%). The average age was 68.5 years. In all cases adenocarcinoma of various differentiation degrees was revealed. Cancer of the large duodenal papilla was in 20 (71.4%) patients, cancer of the common bile duct in 3 patients (10.7%), cancer of the liver port in 1 patient (3.6%), and cancer of the gall bladder in 4 patients (14.3%). Photoditazine and Photosense were used as photosensitizers. In the present work, the researchers evaluated PDT effectiveness for treating inoperable cancer in various departments of the biliary tract depending on the number of PDT sessions and the group of photosensitizers. Patients were divided into several groups. Outcomes were assessed by determining the median survival by Kaplan-Meer methods. Results. The median survival time in the main group was 18 months (minimum -12.5 months, maximum - 24 months); in the comparison group - 11.5 months (minimum - 4 months, maximum - 14 months). The median survival time in the group treated with Photoditazine was 17 months (CI-95%: 12; 21); in the Photosense group - 18 months (CI 95%: 16, 19). There were no lethal outcomes. In patients who had only one PDT session during the year, the median survival was 12.5 months (95% CI: 10, 15); in patients who had 2 or more PDT sessions, the median survival was 23 months (95% CI: 18, 28).

Backgrounds. Damage of the anterior cruciate ligament (ACL) is the most frequent pathology in the knee joint. In traumas and degenerative-dystrophic lesions of the knee joint, one can see tears and defibration of separate bundles with complete or partial damage to the cruciate ligament. Purpose. To develop a combined technique for the treatment of partial anterior cruciate ligament injury using platelet enriched autoplasma (PRP) and laser technologies. Materials and methods. 92 patients (43 females, 49 males) aged 16-58 years were taken into the study. All patients had physical examination, functional X-ray examination and MRI. International scales IKDS KNEE 2000, KOOS were used for evaluating questionnaires. Laser light generated by LSP-IRE-Polyus laser device was used for laser corrective reconstruction of partially damaged fibers in the anterior cruciate ligament. After laser reconstruction, autoplasma enriched with platelets was injected sub-synovially into ACL damaged section. Results. Findings obtained with international scales IKDS KNEE 2000 and KOOS demonstrate a significant improvement in the quality of life of patients because 88% of them were satisfied with outcomes of their treatment.

Background. High prevalence and a poor prognosis of lower-extremity atherosclerotic arterial disease determine it as an actual problem. This pathology is diagnosed in 6 to 23% of patients with intermittent claudication (IC) depending on their age. The main curative technique for treating patients with IC is endovascular or operative revascularization of limbs. However, about 40% of patients have medicamentous therapy that remains the only treatment tactics for them. IC therapy includes drugs affecting microcirculation (MC). Therefore, our better understanding of changes taking place in the peripheral blood flow of patients with clinical manifestations of lower-extremity atherosclerotic arterial disease acquires a special significance. Purpose. To assess skin microvascular functional changes in patients with obliterating atherosclerosis of lower extremities with different IC intensity by the ankle-brachial index (ABI). Materials and methods. The study enrolled 62 male patients with angiographically confirmed obliterating atherosclerosis of lower extremities, IC stage IIb (according to the classification modified by AV Pokrovsky), ABI ≤ 0.85, without blood disease, bronchopulmonary pathology or complex rhythm disorders and with heart failure not higher than II Functional Class. These patients were divided into 2 groups by ABI index. Group 1 included subjects with ABI ≥ 0.55, (n = 44, mean value 0.71 ± 0.14) and Group 2 - with ABI < 0.55 (n = 18, mean value 0.44 ± 0.1). Groups were matched by age (64.02 ± 6,6 vs 60.63 ± 6.1 years), by the number of patients with arterial hypertension (AH), by associated ischemic heart disease as well as by AH grade (mean arterial pressure - 98.4 ± 10.3 mm Hg vs 99.0 ± 0.79 mmHg, respectively). All patients were prescribed basic therapy including statins, aspirin, and antihypertensive drugs, if necessary. Vasolytic drugs were canceled 3 days before the trial. Skin MC was assessed by laser Doppler flowmetry. Results. The analysis of structures participating in the hemoperfusion rhythms has shown a significant increase in the amplitude of neurogenic modulation range in patients from Group 2 compared to Group 1 (0.92 ± 0.77 perfusion units (pfu) vs 0.43 ± 0.25 pfu, (+111%; р = 0.001), respectively) what indicates arteriole dilation. This fact is probably related to ischemic neuropathy with autosympathectomy and loss of neurogenic control over arterial vasoconstriction. At the same time, the myogenic tonus index indicating the state of precapillary sphincters, was significantly higher in patients of Group 2 versus Group 1 (84.9 ± 57.7 units vs 55.0 ± 31.5 units, р = 0.015, respectively) what caused a significant decrease in the nutritional blood flow (by 48.9%; р = 0.01), increased blood flow through arteriole-venule shunts (+107.5%; р = 0.002) and venous congestion. The latter brings more severe disorders in blood rheology. Conclusion. The data obtained demonstrate severe MC disturbances in patients with IC that determine the severity and prognosis of the disease, to a large extent. MC study makes it possible not only to obtain additional objective information on the severity of the disease, but also to identify an appropriate treatment strategy as well as to provide an adequate control in the course of treatment.

The modern trend in surgical technologies is to develop safe and effective approaches for treating patients with various nosologies. Lately, ophthalmic surgeons have been actively looking for new techniques which can give a long-lasting hypotensive effect in patients with glaucoma and can have a low risk of complications. Stimulation of the uveoscleral outflow pathway for the eye fluid is among mostly interesting ones. In this case, sclera becomes a final stage of intraocular fluid flow out of the eye, so the role of its regenerative abilities is of great importance. Multi-year studies showed that light from the eximer laser has a positive temperature effect at the cornea during refractive surgery. Previous experiments on human cadaver eyes showed that thinner sclera has better permeability and has better coefficient of eye fluid outflow. The aim of the present study was to assess the state of eye tissues and reparative processes in them after excimer laser ablation and surgical resection of sclera in vivo. Experiments were conducted on 20 eyes of 10 rabbits of the Chinchilla breed. Excimer laser ablation of sclera to the depth of 200 цш on the right eye was performed using Russian-made excimer laser «MicroScan Vizum» with wavelength 193 нм (0.193 цш); resection of sclera area of 7.0 x 5.0 mm to 2/3 of its thickness was performed with a surgical blade on the left eye. Histological examination was made with stains Hematoxylin, Eosin and Pikrofuksin by Van Gieson. In two months after the excimer laser ablation of sclera, one could see completed regeneration and no inflammatory processes in eye tissues.

Objective. To determine the dynamics of temperature status of the primary node of malignant neoplasms in laboratory animals by the radiothermometry during photodynamic therapy sessions. Materials and methods. The researchers used the adapted technique for controlling temperature fluctuations in the depth of biological tissues. Laboratory mice of C57Bl line with the developed transplantable lung Lewis carcinoma were taken into the experiment. Laser light with wavelengths 660 nm and 1270 nm and variable dose loading was used as a thermomodifying agent. Results. It has been shown that the adapted radiothermometric technique allows to effectively determine the temperature profile of malignant neoplasms during photodynamic therapy and light-oxygen therapy. The information obtained may be used for correcting the mode and dosage of laser treatment during PDT as well as for developing combined thermal therapy and PDT.

Purpose. To study the impact of photosensitizer Radahlorine and photodynamic effects (in vitro and in vivo) at the platelet aggregation activity. Materials and methods. Wistar rats (males) were used in the trial. Platelet-rich plasma (PRP) was taken from the venous blood. Aggregation activity of platelets (Pl) was measured with the turbodimetric technique (analyzer AT-02, Russia), aggregating inductor - collagen (Chrono-Log Corporation, USA) 4 ng/ml. Radahlorine (RH) (Radapharma, Russia) was used as a photosensitizer (PS). PRP samples with PS were irradiated with laser device ALOD-Granat (Alcom Medica, Russia) with wavelength 662 nm, power density - 0.05 W/cm², energy density - 12.5 J/cm², 25 J/cm², 50 J/cm². Results. Dose-depending Pl aggregation inhibition was observed after 5-minute incubation of PRP with RH (10, 20, 40 ng/ml). PRP irradiation (25 J/cm², 50 J/cm²) in presence of RH (14 ng/ml) significantly increased an inhibitory effect. Under the dose equal to 50 J/cm², latent period and PL shape-changing phase after Pl stimulation by collagen were absent, and the aggregation intensity decreased by 3 times. In 3 hours after RH (5ng/ml) intravenous administration, intensity of Pl aggregation did not change significantly, but after PRP irradiation with 25 J/cm² it decreased by 5 times. Conclusion. Radachlorine has a dose-depending inhibition effect at collagen-induced Pl aggregation in rats. Photoactivation increases this effect. One of the probable mechanisms of this effect is photodynamic damage of Pl membrane and impaired activation of glycoprotein receptors responsible for Pl aggregation.

Leukocyte formula and leukocyte coefficients are used as basic indices for determining adaptive reactions. Low-level laser irradiation (LLLI) may serve as a stress corrector. It was found out that the leukocyte formula after LLLI did not differ throughout the study from intact values of neutrophils, lymphocytes and monocytes. In the group of animals which were exposed to stress, there were marked neutrophilia, monocytosis and lymphopenia. In a day after stress, here was a tendency to restoring values to the level of intact ones in those groups where LLLI was applied at the previously alterated organism. The most significant LLLI effect at the stressed body was observed at the initial stage of the study. To assess stress-reactivity, the researchers calculated the index of adaptation tension (IAT) by Garkavi. In LLLI group, IAT decreased by 50% after preliminary alteration, but a week later it returned to intact values. LLLI effect caused the decline in the immunoreactivity index by 19% in an hour after LLLI exposure; but a day later this immunoreactivity index was close to control values. The present trial has shown that LLLI was effective for controlling post-stress disorders and for the activation of some adaptive, protective and compensatory processes.

The article discusses characteristics of laser medical devices working in the range of 1.94; 2.01 and 2.1 gm wavelengths which are used in urology for surgical interventions. As it has been shown, in gaseous media biotissue dissection is made due to a combined effect of light and a candent lightguide tip. In physiological solution, biotissue dissection ( prostate enucleation, removal of nonmuscular-invasive bladder cancer) is achieved due to a two-phase jet of hot water and vapor-gas bubbles formed as a result of ultra-intense boiling of liquid in a thin (about 0.1 mm) layer absorbing laser radiation. Coagulation of the adjacent tissues is achieved due to the heat released during steam condensation.

A technique for monitoring the light dosage during photodynamic therapy of organs in the abdominal cavity with a four-channel fiber-optic sensor has been developed. In the model conditions, temporal and distance dependences of light doses for working variants of therapeutic light field under laser irradiation and for background illumination under standard operating conditions were obtained. The developed computer program for processing obtained measurements allows to digitally display light dose values in real time at four selected points of the operating field with automatic consideration of background irradiation from external sources.