Purpose: To increase the efficiency of treatment and rehabilitation of patients with chronic cicatricial stenosis of the larynx and trachea using laser light after reconstructive surgery on the larynx and trachea. Material and methods. 40 patients with chronic stenosis of the larynx and trachea were divided into two groups: Group I (main) – 20 patients who had laser therapy sessions in postoperative period and Group II (controls) – 20 patients who had no laser therapy. All patients were examined with laser Doppler flowmetry using laser analyzer LAKK 01 with a single-channel tissue probing option. Laser therapeutic apparatus Mustang 2000 with a laser head generating in the red spectrum (wavelength 0.63–0.65 μm, pulse-periodic mode, frequency 80 Hz) was used for laser sessions. Average energy density was 1.5–3.0 J/cm2 . Laser therapy course consisted of 8–10 sessions with average exposure time 5 minutes per irradiated zone; and in case of extensive wound defects, total exposure time was increased by irradiating several fields on the wound surface.

The aim of our work was to study possible changes in the cardio-respiratory system under blue light irradiation with wavelength 470 ± 10 nm. Material and methods. A sample of 5 people (3 men and 2 women, average age 55.7 ± 3.0 years) was taken to study three-month dynamics of heart rate and its variability, blood pressure and its variability, cardiac function, respiratory function. Parameters after loading tests before and after travelling to other climatic and geographical conditions and parameters under various level of physical activity were analyzed as well. Subjects from the experimental group had daily phototherapy sessions with blue light generated by bracelet BASI – an autonomous light-emitting device (two sessions of 15 minutes each). In the control group, there were 3 men and 3 women of the same age and body type who spent their experimental time in the Central Russia. Measurements were made with a tonometer and with a device called “spiroarteriocardiaorhythmograph” in three test variants: without a spirometrical mask, with the mask and voluntary breathing (imitation of light hypoxia) and with controlled breathing having frequency 6 cycles per minute. Level of parameter changes was analyzed every experimental month. The discriminant analysis algorithm (direct step-by-step analysis) was applied. Results. It has been found out that preventive phototherapy with blue light courses changes in the cardio-respiratory function which reach the level of statistical significance in case of controlled breathing test.

Purpose: To study the effectiveness of laser therapy in the correction of hepatic encephalopathy in severe mechanical jaundice of pancreatogenic origin. Material and methods. 30 patients with severe mechanical jaundice of pancreatogenic origin were taken into the study and divided into two groups: Group 1 – 15 patients who had standard therapy; Group 2 – 15 patients who had standard therapy plus laser therapy (transcutaneous quantum irradiation in the projection of the cubital vein for 15 minutes and in the projection of common carotid and vertebral arteries for 5 minutes on each side). 10 healthy individuals were taken as controls. For laser therapy, laser device “Matrix” with KLOS head was used (wavelength 635 nm, power 2 mW; registration certificate No. FSR 2007/00589, certificate of conformity ROSS RU.AV35.D00082). Assessment of microcirculation (microcirculation index – MI, index of microcirculation efficiency – IME and bypass rate – BR) was made using Doppler flowmeter (Ltd “Lazma”, Russia) findings. Liver functional status was assessed by the activity of alanine aminotransferase (ALT) and by the level of total bilirubin in blood plasma. Results. As it has been found out, in case of obstructive jaundice of pancreatogenic origin, liver damage is associated with significant microcirculatory disorders which are recorded on the first 8 days since therapy starts. If to include subvascular laser irradiation of blood into the complex treatment, one can have a relatively rapid restoration of liver functional status what can be explained by the ability of the discussed laser therapy technique to correct microcirculatory shifts.

Objective: To analyze changes in tissue blood flow, metabolic processes and reactivity of skin microvessels after helium-neon laser irradiation in athletes at rest and after physical loading. Material and methods. 37 athletes were examined. They were divided into two groups: main group (MG) 22 athletes and comparison group (CG) 15 athletes. Sportsmen were irradiated with low-level infrared laser light generated by two-channel therapeutic modernized device «Uzor-A-2K» (registered by Roszdravnadzor). Wavelength 0.89 µm, exposure 4 minutes, two light emitters, pulse repetition rate 1500 Hz. Cubital veins were irradiated at the procedure. Output power 3.6 W. Hemomicrocirculation was examined with laser Doppler flowmeter LAKK-M (LAZMA Ltd, Russia) on the palm side of a finger. Results. While comparing results of examination of subjects from MG and CG, it was found out that in MG perfusion rate increased by 24%, specific oxygen tissue consumption – by 8%; rate of oxygenation of mixed blood microcirculation decreased by 8%; redox reactions in mitochondria increased by 38% (p < 0.05). In athletes from MG, there was a significant reduction of microvascular tone due to neurogenic, myogenic and endothelial components. During load testings, sportsmen from MG had statistically significant increase in their specific activity. Conclusion. Low-level laser light, being used as a restorative tool, increases perfusion and metabolism in microcirculation, thus, increasing specific physical activity in athletes.

Purpose: To improve the efficiency of surgical treatment of patients with lichenoid lesions of oral mucous using high-level laser light. Material and methods. 102 patients (78 women and 24 men) aged 24–81 with erosive-ulcerative and hyperkeratotic form of the lichen planus of the oral mucous were examined and operated. All patients were randomly divided into four groups: in Group 1 (n = 25), lichenoid lesions were excised with Er: YAG laser scalpel in the ablation mode; in Group 2 (n = 23), Nd: YAG laser light was used to ablate the affected areas; in Group 3 (n = 28), patients were operated on with the technique combining Er: YAG and Nd: YAG laser light for ablation and coagulation; in Group 4 ( control group) (n = 26) scalpel No 15 C was used. Results. Findings of biochemical analyses have shown that patients operated with laser light had less pronounced inflammatory response what can indicate less trauma to tissues. It has been clinically shown that laser surgical technologies in patients with oral mucous lichen planus had a decreased intensity of pain and collateral edema; wound healing process was shorter compared to patients operated on with a scalpel. Conclusion. Laser technologies having intraoperative advantages and more favorable postoperative period, if to compare to traditional techniques, improve the effectiveness of surgical treatment, reduce the rate of complications and disease recurrences. As it has also been shown by our trial, that Er: YAG laser is preferable in patients with erosive-ulcerative form of lichen planus, while Nd: YAG laser is preferable in case of damaged mucous membrane till muscle layer; for the hyperkeratic form, combination of Er: YAG and Nd: YAG lasers is recommended.

Purpose. To make a comparative analysis of outcomes in patients with hygroma (ganglion) treated with percutaneous intracavital laser obliteration under ultrasound control and with traditional surgical excision. Material and methods. 142 cases of hygroma of different locations were analyzed. Patients were divided into two groups. In Group 1 (98 patients), hygroma percutaneous laser obliteration under ultrasound control was made out-patiently; in Group 2 (44 patients), surgical ganglionectomy was made in-patiently. Laser surgical apparatus LSP «IRE-Pole» with wavelength 1.56 μm was used. Irradiation power was 2–3 W, operating mode was continuous. Exposure time from 20 seconds to 3–4 minutes. Power level and exposure time depended on the size of hygroma cavity. A portable ultrasound scanner controlled navigation and effectiveness of laser irradiation. Results. All patients from Group 1 had no pain in the postoperative period; excellent cosmetic and functional results were seen in 90.8% (n = 89) of them after a single laser procedure. 9.2% (n = 9) of patients required a repeated session of ganglion laser obliteration. Patients from Group 2 had their ganglion excision in the hospital; they needed analgesics in the postoperative period. A postoperative scar was formed in these patients too. Average terms of temporary disability in them was 6 times longer than in patients from Group 1. Recurrence rate – 3.2%. Conclusion. Percutaneous hygroma laser obliteration under ultrasound control is a little-traumatic and effective out-patient treatment with good outcomes.

In the given paper, one can find indications for YAG-laser surgery in eye diseases in children which had been developed due to 27-year experience of the authors. Material and methods. The authors have analyzed 5 085 YAG-laser reconstructive interventions performed in 1991–2018. Patients aged from 2 months up to 17 years. 1/3 of children were younger than 3. More than half of laser surgeries (61%) were made under general anesthesia. Results. Reconstructive efficiency of laser reconstructive surgeries for various eye diseases in children ranged from 87.7 to 97.3%; optical effect – up to 89.3%, visual acuity increased in 75% of children. After analyzing the obtained findings, the authors have developed indications for laser ophthalmic surgeries in children. Conclusion. It is recommended to use YAG-laser reconstructive surgeries more widely in pediatric practice for congenital, post-traumatic, post-inflammatory and postoperative eye pathologies what will reduce the number of children who are unreasonably subjected to repeated instrumental surgical operations with eyeball opening.

Prevention of postoperative hernias of the anterior abdominal wall is an actual problem of abdominal surgery. Impairments in the quantitative ratio of collagens of types I/III negatively affect characteristics of the forming connective tissue what leads to the formation of hernia recurrences. Purpose. To study effects of laser light irradiation of bone marrow location zones at the number and ratio of collagen types I and III, at the number of fibroblasts, at the area of vascular bed and morphofunctional activity of mast cells in the forming connective tissue scar. Material and methods. 20 laboratory rats with postoperative ventral hernia were taken into the experiment. They were divided into two groups: control and experimental. Zones of bone marrow in experimental animals were irradiated with laser light (980 nm, power 1.0 W, continuous mode, 300 s, five sessions ). In 30 days after hernia modeling, tissue samples were fixed in formalin; histological sections were prepared; area of vascular flow, level of fibroblasts, mast cells, and their morphofunctional activity were studied with the morphometric method. The level of collagens of type I and III was studied with the immunohistochemical method. Results. Laser exposure to bone marrow significantly increased type I collagen level and ratio of type I and III collagen; it also increases the number of fibroblasts, area of vascular bed, morphofunctional activity of mast cells in tissues of the anterior abdominal wall in rats with a model of postoperative ventral hernia. These promising findings may promote further researches on developing a technique for preventing hernia formation.

Purpose: To assess the effectiveness of photodynamic therapy (PDT) with photosensitizer Photoditazine complexed with amphiphilic polymers in the treatment of experimental gunshot wounds of soft tissues. Material and methods. Experimental studies were conducted on 50 non-linear rats, divided into 3 groups, depending on the curative modality: controls – traditional treatment; experimental Group 1 – PDT with Photoditazine in the form of 0.5% aqueous solution; experimental Group 2 – PDT with the complex of microencapsulated Photoditazine 0.1% – amphiphilic polymer. To treat wounds with PDT, AKTUS-2 device of Russian production was used. Wavelength of laser irradiation 661 ± 0.03 nm; power density 1 W/cm2 ; energy density 50 J/cm2 . Findings obtained after cytological and histological examinations were analyzed by the authors. Results. In 10 days after PDT, smears showed active proliferation as well as differentiation of reparation elements in Group 2. The increase of mononuclear elements up to 9.4 ± 0.8% and of the total number of young and mature fibroblasts were noted as well. If to compare these parameters with previous comparison groups, wound exudate contained twice more cellular reparation elements, and there were no degeneratively altered neutrophils. PDT with Photoditazine complexed with amphiphilic polymers stops disorders in the microcirculation system and activates the alternative-exudative phase of inflammation. Moreover, in the concussion zone, development of secondary necroses is limited, and the viability of damaged tissues is restored. Conclusion. PDT with a complex of microencapsulated Photoditazine and amphiphilic polymer leads to a quick restoration of viability in damaged tissues in the concussion zone, to early development of reparation processes, to expressed macrophage activation, to stimulation of angiogenesis and collagenogenesis as well as to the accelerated scarring and epithelization of wound defects in experimental gunshot wounds of soft tissues.