Purpose: To study effectiveness of low-level laser therapy (LLLT) and unloading curative gymnastics (UCG) in the treatment of patients with severe arterial hypertension (AH). Material and methods. 58 patients with severe hypertension were divided into two comparable groups: studied group – 30 patients who had LLLT and UCG; control group – 28 patients who had only supportive medicamentous therapy. In both groups, before and after treatment, the following parameters were registered: systolic, diastolic, mean pressure; regional vascular resistance at rest and at the peak of reactive hyperemia; venous tone and blood flow at rest and at the peak of reactive hyperemia. UCG was personalized for each patient. Before UCG, patients had LLLT sessions with red and infrared laser light up to 20 minutes. LLLT course had 10–15 sessions. Results. Initially, in both groups, there was revealed a significant increase in systolic, diastolic, mean arterial pressure and the increase in regional vascular resistance at rest and at the peak of reactive hyperemia; the venous tone under reduced blood flow was decreased at rest as well as the reserve blood flow. After treatment, in the studied group, there was a significant increase in blood flow at rest and in the reserve blood flow; decrease in regional vascular resistance at rest and under functional loading test and in venous tone; decrease of systolic, diastolic and mean arterial pressure. A significant reduction in blood pressure in the studied group was accompanied by the evident improvement in patients’ clinical status and by the improvement of their quality of life. In the control group there was no positive dynamics. Conclusion. LLLT and UCD in the complex treatment of patients with severe hypertension correct the peripheral vascular system manifested with a reliable increase of blood flow at rest and the reserve blood flow; decrease of the peripheral vascular resistance at rest and under functional loading tests; decrease in the venous tone. These positive changes contributed to a significant decrease of blood pressure parameters: systolic, diastolic and mean.

Acute pain in the lumbar spine is one of the most common reasons for patients to seek medical help. In most cases, pain in the lower back is associated with degenerative diseases of facet joints. The effectiveness of surgical treatment of the symptomatic facet syndrome depends on the correct preoperative planning and the choice of type of surgical intervention. Purpose: To analyze effectiveness of laser denervation technique applied in lumbar spine facet joints for treating patients with the isolated facet syndrome. Material and methods. 419 patients aged 61 ± 15 with verified isolated facet syndrome (with provocative samples) were taken into the study. All of them had laser denervation of facet joints in 2012–2016. To assess clinical efficacy of the technique, visual analog pain scale (VAS), Oswestry questionnaire for patients with spine problems and Macnab satisfaction scale after the performed surgery were used for this. Dynamic evaluation was performed in 36 months, on average, after the surgical intervention. Results. It has been found out that laser denervation of facet joints is an effective minimally invasive technique for treating the isolated facet syndrome caused by degenerative lesions of facet joints in the lumbar spine. In early and late postoperative periods the operated patients have a persistent reduction of pain and improved quality of life with low risks for perioperative complications.

Purpose. To study the efficiency of puncture interstitial laser obliteration of pilonidal sinus (PS) under ultrasonic control and to compare it with traditional surgical interventions. Material and methods. The authors have analyzed results of treating 363 patients with PS for the last 10 years. The puncture interstitial laser obliteration technique under ultrasonic control was used in 184 patients with PS in the studied group. Other 179 patients were operated on with the traditional technique consisting of cysts excision and primary suturing. Results. Surgery in the studied group lasted for 14,3 ± 3,6 minutes, while in the comparison group – 36,6 ± 5,2 minutes. Intensity of pain syndrome in the studied group was minimal – 1,2 ± 0,2 points according to the pain scale, while in the other group – 5,7 ± 1,6 points. Hospital stay in the studied group did not exceed 3 days, while in the comparison group it was more than 12 days. Patients from the studied group could resume their work three times more quicker. Long-term results in patients from the studied group did not differ significantly, if to compare with the other group, while their satisfaction after surgical intervention with laser obliteration was much better. Conclusion. The obtained results allow us to recommend the discussed technique for clinical practice.

Objective: To evaluate the effectiveness of YAG-laser vitreolysis using the quantitative assessment of floating opacities in the vitreous body. Material and methods. In September 1, 2016 – March 26, 2018, YAG-laser vitreolysis was performed in 191 patients (228 eyes). The indication for the operation was floating opacities of the ring Weiss type and absence of retina pathologies. Patients’ age – 36–86, average age – 63.2 ± 9.9. Men – 35, women – 156. Before and after the surgery there were performed traditional and additional examinations: ultrasonography, optical coherence tomography (OCT) with angiography function, scanning laser ophthalmoscopy. Results. Findings of OCT-angiography examination of 228 eyes in the postoperative period showed residual opacities in the form of artifact shadow on the retina surface at the following periods: one day – in 52 eyes, 1 week – in 12 eyes, 1 month – in 5 eyes, 3 months – in 1 eye. All patients had an additional session of laser vitreolysis. Next examination in 6 and 12 months did not reveal any opacities. According to the survey, total patients’ satisfaction was 89.5%. Conclusion. The quantitative assessment of floating vitreous opacities, determined by the area of the artifact shadow on the retinal surface with OCT-angiography, is an objective method for optimizing indications for laser vitreolysis and evaluating the effectiveness of treatment in the postoperative period.

Confocal laser endomicroscopy is a rapidly developing direction that allows to create a bridge between endoscopy and histological examination in the real-time mode. This latest technology has made it possible to study the microstructure of mucous membrane of gastrointestinal tract in vivo during endoscopic examination (“virtual biopsy”) and is of increasing interest in clinical practice. To study colon, confocal endomicroscopy is justified for the differential diagnostics of polyps and assessment of colon state in patients with inflammatory bowel diseases.

Purpose: To develop techniques and to assess effectiveness of laser light irradiation for preparing extensive purulent wounds in soft tissues for plastic surgery. Material and methods. Four groups of patients were taken into the study depending on the technique selected for the preparation of purulent wounds in soft tissues for plastic surgery. Group 1 – traditional surgical treatment of purulent foci with bandages impregnated with antiseptics and ointments. Group 2 – irradiation of purulent wounds with semiconductor laser light, and postoperatively, with low-level laser light. Group 3 – wound irradiation with semiconductor laser light; after that PDT (photodynamic therapy) sessions. Group 4 – in addition to laser treatment during surgery and PDT sessions, NO-therapy of wound surface was made. Effectiveness of various techniques applied in these wounds was assessed by the number of repeated necroctomies, by the dynamics of wound process, by length of stay in the hospital, time for complete wound healing, and by patients’ satisfaction with functional and cosmetic results. Results. Under traditional surgery and local treatment of purulent wounds, 6 out of 50 patients (12%) on day 2–5 after the primary surgical treatment required repeated necrectomy because of the formation of secondary necrotic foci in soft tissues. In Groups 2, 3 and 4, no repeated necrectomies were required. Conclusions. High-level laser light applied during the surgery and low-level laser light applied postoperatively plus PDT and NO-therapy for purulent wounds have produced an additional curative effect at them which signifcantly reduced hospital stay and led to complete healing with better functional and cosmetic outcomes if to compare with traditional treatment.

Objective. To optimize the energy impact at the venous wall in endovenous laser ablation (EVLA) with a radial fiber. Material and methods. Illumination parameters of various models of headpieces put at the distal part of laser fibers have been compared. Experiments were performed with original models of headpieces which had in-built hollow toroidal chambers of various shapes and the inner surface of which was formed on the Catalan surface: hyperbola, circuit and two kinds of parabolas. As a control, the researchers used a known model of headpiece, i. e. without the toroidal chamber. Illumination parameters of headpieces were measured with luxometer LX1330B in four positions with headpiece rotation angles equal to 90°, 180°, 270° and 360°. Results. The experimental work has shown that any of new headpiece models has better irradiating capacity, if to compare with the famous prototype. A headpiece model with the parabolic shape of toroidal chamber has the best radiating, aligning and focusing capabilities. Conclusion. A new headpiece for the distal part of laser fiber with the hollow toroidal chamber brings better energetic effect at the venous wall during EVLA procedure. Application of several toroidal chambers of various shape with different linear energy densities allows to develop a new approach for EVLA therapy when the differential force effect is applied to biological structures of the venous-blood matrix.

Laser irradiation has been successfully used to correct hypothyroidism in clinical practice. Laser light irradiation can affect functional parameters of both the thyroid gland and parathyroid glands, since they form a single morphofunctional complex. The aim of the present work was to study the effect of infrared laser irradiation of the location of thyroid and parathyroid glands at parathyroid hormone (PTH) levels in normal conditions and in hypothyroidism. The applied laser light had total density dose on skin surface 112 and 450 J/cm² per. 78 male laboratory rats were used in the trial. It has been shown that laser exposure significantly changes PTH levels in both intact animals and animals with hypothyroidism model depending on the dose density.