Objective. To study the effectiveness of endovascular laser coagulation in patients with recurrent varicose veins in their lower extremities.

Material and methods. Outcomes after the treatment of 54 patients with varicose vein relapses in the lower extremities were analyzed. Under the tumescent anesthesia, endovascular laser coagulation was made: in 5 patients – stump of the great saphenous vein; in 22 patients – recanalized, residual and preserved subcutaneous venous trunks; in 27 patients – insufficient communicating veins of the thigh and lower leg.

Results and discussion. In average, surgery lasted for 31 ± 0.6 minutes; intensity of the postoperative pain syndrome was 3.4 ± 0.4 points. Early postoperative complications were registered in 1 (1.8 %) patient, side effects in the form of hyperpigmentation and paraesthesia – in 4 (7.4 %). In 12 months, all operated patients demonstrated an improvement in all parameters of their quality of life by 29.2– 40 %; cosmetic outcome after surgery was 7.8 points out of a ten-point scale. The long-term observation revealed the relapse in varicose veins only in 1 (1.8 %) patient.

Conclusion. The justified use of endovasal laser coagulation in patients with relapses of varicose veins in the lower extremities allows to avoid manipulations in the area of scar-altered tissues, to reduce tissue damage and duration of surgery, to improve patients’ quality of life, to avoid additional incisions as well as to improve cosmetic outcomes after surgery.

Objective: To study features of nonlinear dynamic and oscillatory processes in the skin microcirculatory flow in patients with obliterating atherosclerosis in lower extremities arteries (OALEA).

Material and methods. 56 male patients with obliterating atherosclerosis in the arteries of lower extremities and 15 practically healthy individuals were taken into the study. Microcirculation in the skin on feet with the assessment of nonlinear dynamic processes and spectral wavelet analysis of blood fl ow fl uctuations was studied by laser Doppler flowmetry, device “LACK-M” (firm Lazma, Russia). Normalized amplitude parameters of blood flow fluctuations in frequency ranges of hemocirculation tonus-forming factors were analyzed: endothelial, neurogenic, myogenic. Myogenic microvascular tone and capillary blood flow indices were calculated. To study nonlinear dynamic processes, the following parameters were assessed: fractal dimension, entropy and phase portrait analysis.

Results. Spastic-atonic microcirculation disorders were revealed in patients with OALEA. They were characterized with metarteriole constriction and with restriction of capillary blood flow, with an increased myogenic tone and dilated arterioles. Statistically significant shifts in parameters of nonlinear dynamics in this case- in particular, decrease in entropy (–10.6 %) and in dimensions of phase portrait (–9.3%) under energy deficit in oscillatory microcirculation processes (–20.8 %) – can be interpreted as a decrease in complexity of laser Doppler flowmetric signal and better ordering in regulatory mechanisms of the peripheral blood flow.

Conclusion. In patients with obliterating atherosclerosis in the arteries of lower extremities, the obtained results indicate significant functional microcirculation disorders of the spastic-atonic nature leading to the restriction of nutritive blood flow and accompanied by the lack of energy in oscillatory processes. These results have also shown the decrease in the system chaos severity which indicates limitation of connections of microcirculation control factors, simplification of the mechanisms of functioning of the microvascular bed and, as a consequence, decrease in the compensatory adaptive potential.

A clinical case of a combined application of photodynamic and light-oxygen therapy in a patient with vulgar acne is described. For photodynamic therapy, photosensitizer “Sigrinol” and mercury-quartz irradiator on a tripod ORK-21M with a radiation source lamp DRT 400 were used. For light-oxygen therapy – “Super Seb” diode laser. After the treatment complete clinical remission was achieved.

Purpose. To assess microcirculation and mechanisms of its regulation in the liver after its extended resection.

Materials and methods. 10 Wistar rats of both sexes weighing 180–270 g which had median laparotomy under general anesthesia were taken in the trial. Microcirculation in the liver of rats was assessed with LAKK-02 Laser-Doppler flowmeter (Russia). A light guide for determining microcirculation was placed on the visceral surface of the right liver lobe; parameters of Laser-Doppler flowmetry (LDF-gram) were registered for 7 min. Then, ligatures were sequentially applied to the left lateral and median lobes of the liver followed by their cutting off; then, about 70 % of the organ were removed. After removal of both liver lobes, LDF-gram was recorded again for 7 minutes with a sensor placed on the visceral surface of the right liver lobe. Basic microcirculation parameters were registered before and after extended liver resection.

Results. After the extended liver resection, average arithmetic parameters of microcirculation in the liver parenchyma decreased by 11.71 % (p < 0.05), which indicates the decrease in the microvasculature perfusion. At the same time, indicators of standard deviation of the microcirculation index and the coefficient of variation did not change statistically significantly. The median maximum amplitude of neurogenic oscillations after the resection increased by 2.3 points (p < 0.05). The amplitude of myogenic oscillations also increased after resection (p < 0.05); however, the degree of increase was less than that of the neurogenic rhythms. It was found that in 70 % of animals the maximum amplitude of endothelial oscillations increased in the liver microcirculation after the extended resection; however, in general, differences between the average endothelial oscillations before and after the resection were not statistically significant.

Conclusion. In the experimental liver resection, the most informative and reliable LDF criteria on ischemia development in the liver stump were average arithmetic microcirculation indices as well as the amplitude of neurogenic and myogenic oscillations. The authors emphasize that the degree of changes in these indices may be a sign of ischemia severity in the liver stump after its resection and may have a prognostic value, although the results obtained require further research.

The authors present a review on endovasal techniques applied for the treatment of varicose veins in the lower extremities. These techniques are minimally invasive, though are not universal. They still have complications and relapses. To select the most effective one among them is not an easy task. We are facing the need to improve the existing modalities and to look for the new ones aimed to personalize care for each patient.

The authors have reviewed researches on laser palate surgery and stages of its historical development for providing surgical care to patients with ronchopathy and the obstructive sleep apnea syndrome. They also assessed the effectiveness of traditional techniques for uvulopalatoplasty as well as the effectiveness of laser light application in uvulopalatoplasty and its modifications.