Purpose. To assess the effectiveness of curative complex consisting of photodynamic therapy (PDT) + intravenous laser blood irradiation (ILBI) + local tumor irradiation (TR) at hemostatic parameters at the initial stages of squamous cell skin cancer (SCSC).

Material and methods. The present work analyzes SCSC course in 185 patients who had outpatient and inpatient treatment in medical institutions of cities Engels and Saratov in 2015–2019. 129 (69.7%) males and 56 females (31.2%). Patients were divided into three groups. Group I – 74 (40%) patients who had combined treatment: surgery with wide tumor excision under intravenous anesthesia + PDT + ILBI + TR; Group II – 111 (60%) patients who had only surgical treatment. Group III was created for controlling and comparing the obtained laboratory parameters; it included 17 patients without established pathology.

Results. It was found out that hemostatic disorders in SCSC are characterized by increased activity of AT III and vWF and by simultaneous decrease of tPA-PAI-1 complex as well as by increased activity of VIIIa factor and resistance of Va factor – indices which indicate dysfunction of endothelial vascular wall. Combination of PDT + ILBI + TR prior to surgical treatment in patients with squamous cell skin cancer at the initial stages of the disease allow to normalize homeostatic indices and reduce the number of complications.

Conclusion. 1. Squamous cell skin cancer at the initial stages changes the hemostatic system. 2. Effects of SCSC mechanism may be characterized as follows: damage of the endothelium vascular wall which is confirmed by endothelin increase; it results in vasoconstriction and increased blood procoagulant activity and, ultimately, in changes of hemostatic parameters. 3. Combination of PDT + ILBI + TR applied before surgery in patients with squamous cell skin cancer at the initial stages of the disease normalizes homeostatic indices and reduces the number of complications.

Background. The discussed topic is worth attracting attention because of its high mortality rate in patients with acute renal damage which is caused by urological and surgical diseases. The membrane-destructive component in damaged renal tissues is manifested with decreased glomerular filtration rate, increased endotoxin level and lipid aberrations. The standard infusion and antibacterial therapy does not fully compensate the severity of pathological changes.

Purpose. To study the effectiveness of low-level laser irradiation at endotoxicosis and lipid metabolism indicators in acute renal damage in acute experimental peritonitis.

Material and methods. Lipid peroxidation, membrane-destructive processes in renal tissues as well as lipid metabolism and endotoxicosis were studied in the experiment with dogs. The effectiveness of infusion and antibiotic therapy and combined therapy with laser light were compared.

Basic results: the experiment has demonstrated that acute renal damage was caused by systemic inflammatory diseases of non-urological profile. The applied low-level laser irradiation (LLLI) promoted more rapid correction of pathological processes which were manifested with increased concentration of cholesterol esters, total phospholipids, phosphatidylserine; LLLI decreased levels of cholesterol, phosphatidylcholine, triacylglycerol, phosphatidylinositol, triacylglycerol, phosphatidylinositol, diacylglycerol, lysophospholipids, free fatty acids and endotoxicosis parameters.

Conclusion: the obtained results reliably indicate a LLLI positive effect at the organism’s potentials to recover when LLLI is included into the comprehensive therapy (under experiment). This is evidently seen in the restoration of lipid component in elements of renal parenchyma and in the decrease of lipid peroxidation activity.

Background. Detailed study of the functional state of microcirculation in combination of arterial hypertension and tobacco smoking, as the most common and prognostically important risk factors for atherogenesis, will not only clarify pathogenetic effect of tobacco smoke on the terminal vascular bed, but also outline directions of active counteraction to it.

Purpose. To study the effect of TS on the functional state of SM using laser Doppler flowmetry in patients with AH.

Methods. 185 patients with stage 1,2 AH involved in the study were divided into 2 equivalent groups according to main clinical and laboratory data: group 1 – non-smokers (n = 134, mean age was 57.0 [50.0; 60.0]), group 2 – patients who smoke 1–1.5 packs of cigarettes per day (n = 51, mean age was 54.0 [48.0; 58.0]). Patients were prescribed short-acting antihypertensives drugs, which were used whenever required 5 days before the study. SM was investigated by laser Doppler flowmetry using occlusion test and amplitude-frequency spectrum analysis of hemoperfusion fluctuations.

Results. Obtained data showed negative acute effect of ingredients of tobacco smoke on almost all structural elements of microhemocirculation. Revealed deviations are characterized by constriction of precapillary segment of microvascular bed with increase in myogenic tone and equal 3.1 units [2.6; 4.1] versus 2.3 units [1.7; 3.4] in the alternative group (p = 0.007), decrease in capillary blood flow from 4.5 units [3.5; 5.8] compared with the group of non-smokers – 5.2 units [4.0; 7.3] (p = 0.041), statistically significant intensification of arteriolar-venular blood flow with formation of venous congestion, limitation of dilated reserve of microcirculation.

Conclusion. Tobacco smoking leads to significant microcirculation disorders that are projected onto changes in terminal vascular bed, inherent with AH, which significantly reduces the functional state of microcirculation, limits its reserve potential and promotes the development of tissue ischemia.

The work carried out a comparative analysis of the results of surgical treatment of the epithelial-coccygeal course of ECC in 133 children aged 3 to 17 years, using laser-induced interstitial thermotherapy (LIT) and open excision. Comparative analysis was carried out according to the following criteria: duration of surgery, average time of hospital stay, duration of pain syndrome on a 10-point scale (VAS), the presence of complications in the early and late postoperative period. In the main group, the average time of hospital stay was 4.9 ± 0.3; the duration of surgical treatment was 17.2 ± 2.8 minutes. The duration of the pain syndrome was 5.3 ± 2.1 hours, and its severity was 2.7 ± 0.8 points. Average terms of epithelialization of fistulas are 3.1 ± 2.8 days. Recurrence of ECC was observed in 7 patients (11.7%), which required re-intervention. In 3 (5.0%) patients, LIT was used, and in 4 (6.7%), excision using plastics according to the Bascom method. In the comparison group, the duration of surgical treatment was 32.6 ± 5.4 minutes. The duration of inpatient treatment is 16.7 ± 1.4 days. Pain syndrome averaged 71.8 ± 11.9 hours, severity 6.5 ± 2.3 points. The number of relapses was 9 (12.3%), of which 5 (6.8%) children underwent laser treatment, and 4 (5.5%) repeated surgical excision with Bascom with recovery. This technique is an effective and minimally invasive method for treating ECC, which makes it possible to recommend this method for use in pediatric surgical practice.

The researchers discuss the first experience of treating 9 pediatric patients with osteoid osteoma (3), primary chronic osteomyelitis (4) and aneurysmal cysts (2). Selected patients had complex treatment which included unloading of the diseased segment of the skeleton and laser ablation of the pathological focus. Laser ablation was done with medical laser «AZOR-ALM», emitting light at wavelength 1.55 μm. Registration certificate No. RZN 2015/2720 of Roszdravnadzor. Manufacturer – LLC «AZOR» (Moscow). Small tumors and inflammatory diseases of the skeleton were surgically treated with high-level laser light in the computed tomography room. Patients with lesions of lower extremities and pelvis previously had spinal anesthesia. If a pathologic focus was located in bones of upper extremities, regional brachial plexus blockage was preferable. In all cases, positive outcomes were seen. Follow-up lasted for 6 months.

Rationale. The existing techniques for treating skin capillary angiodysplasias, including «laser» photodestruction, are not effective enough and often cause undesirable thermal damage and cicatricial deformities of the skin. Thus, the effective removal of this vascular pathology is still relevant and requires further solution.

Purpose. To study the nature of thermal injuries and wound regenerative processes after «green» laser irradiation with wavelength 525 nm so as to find out if it may be used for selective photodestruction of subepithelial pathological vascular structures, including angiodysplasias of skin capillaries.

Material and Methods. Scallops of alive white chickens were taken as a biological model of vascular structures for in vivo studies. An experimental solid-state laser generating «green» light with wavelength 525 nm was used. This laser light has similar peaks of the absorption coefficient of hemoglobin and oxyhemoglobin which are found in skin capillaries. Features of damage and dynamics of regenerative process in the irradiated area were studied at the model of vascular structures using findings of morphological macroscopic and histological examinations.

Results. Findings of the present experimental trial have inspired that selective photodestruction of subepithelial vascular structures of scallops is possible with minimal damage to the epithelium, including growth zones. In irradiated areas, one could see whitening and smoothing of the surface due to closure of vessel lumens in the subepithelial zone and formation of collagenosis layer there, as well as epithelialization of wound surface in physiological terms without any formation of cicatricial deformation of the skin.

Conclusion. The selective effect of 525 nm «green» laser light at subepithelial vascular structures with minimal skin damage has been confirmed. It opens a way to apply this light for selective photodestruction of capillary angiodysplasias of the skin with good clinical and esthetic outcomes.

It is given a literature reference on the etiology, frequency and mechanisms of development, features of the clinical presentation and treatment options for skin cancer that has developed on scars. It is presented a detailed clinical observation of a patient with squamous cell skin cancer in the area of the right elbow joint, which occurred 67 years after the kerosene lamp burns of the skin of the right upper limb and the right half of the chest. The patient was initially treated with electron radiotherapy in the total focal dose 60 Gy with a partial effect, but after 10 months a relapse was diagnosed, for which multi-course photodynamic therapy was performed with a Photolon photosensitizer at a dose of 1.1 mg/kg; the way of light delivery was polypositional interstitial and distant, the laser radiation power density was 0.30 W/cm2, the laser radiation energy density was 200 J/cm2. The result of treatment is complete regression of the tumor, the patient was under regular observation without any signs of local, regional and distant metastasis. After 3 years, by the absence of signs of local relapse, the disease progression was diagnosed: metastatic lesion of the axillary lymph nodes on the right and multiple metastases in the lung tissue of both lungs. Treatment was performed: axillary lymphadenectomy on the right, targeted therapy with IgGl monoclonal antibodies directed against the epidermal growth factor receptor; on this background stabilization of the process was noted.

Benign prostatic hyperplasia – one of the most common diseases in older men. The treatment strategy for benign prostatic hyperplasia consists in its drug therapy, or active surgical tactics. The indication for planned surgical treatment of benign prostatic hyperplasia is the progression of symptoms of the lower urinary tract, which are not amenable to drug correction. Men with a large prostate volume of more than 80 m³, with severe symptoms of the lower urinary tract, with a history of acute urinary retention episodes, represent a difficult group of patients in terms of choosing the tactics of surgical treatment. This article discusses the most common operations that are used in the treatment of benign prostatic hyperplasia (especially of large sizes): open adenectomy, transurethral resection of the prostate gland, enucleation of benign prostatic hyperplasia using a holmium laser, embolization of an artery of the prostate gland. Surgical treatment of benign prostatic hyperplasia requires an individual approach to the patient, taking into account his age, concomitant pathology and clinical symptoms.