Purpose. To compare surgical outcomes when analyzing the dynamics at the microvascular level. Material and methods. Outcomes of 831 surgeries for coronary artery bypass grafting (CABG) in patients with ischemic heart disease (IHD) have been evaluated. The studied patients were divided into three groups: CABG in patients without any diffuse lesions of coronary arteries (group I - 711 patients), CABG in patients with diffuse lesions of coronary arteries (group II - 33 patients) and CABG plus transmyocardial laser revascularization (TMLR) in patients with diffuse changes in coronary arteries (group III - 87 patients). The assessed findings were obtained with intraoperative EchoCG and coronary shuntography, analyses of cardiac enzymes (CPK and CPK-MB) as well as intra- and postoperative indexes which reflected patients’ state. Results. The critical spasm of coronary arteries in group I was seen in 1.7% of cases, in group II - in 33.3%, in group III - in 1.15%. As far as the patients from group I and group II were differed only by the presence or absence of diffuse changes of their coronary arteries, it appears that the critical spasm develops (and/or worsens) mostly in patients with diffuse changes of coronary arteries. The only difference in patients from group II and III was the volume of surgery, so the obtained findings indicate that TMLR in addition to CABG prevents developing the critical spasm in coronary arteries. Conclusion. The risk of intraoperative spasm in coronary arteries is predisposed by diffuse changes in coronary arteries, including those at the microvascular level. TMLR performed in addition to CABG in patients with IHD and diffuse lesions in their coronary arteries improves bypass patency and increases blood flow in coronary arteries.

Рurpose: To assess the effectiveness of radiofrequency obliteration (RFO) and laser ablation of varicose veins in patients with varicose disease. Materials and methods: 419 patients with varicose disease were taken into the study. 364 out of them had a combined therapy which included RFO of the large subdermal vein stem. 55 had endovasal laser obliteration (EVLO). Results: The intensity of postoperative pain in RFO group was 2.9 ± 0.6. Transient paresthesias were seen in 14 (3.4%) cases. Local ecchymoses were in 18 (4.3%) cases. Consequences of tumescent anesthesia were the following: local ecchymoses and hyposthesia resolved in 3-5 days. In one case skin pigmentation persisted up to 3 months. There were no complications like burn, infiltrate, suppuration, thrombosis, pulmonary artery thrombosis. In EVLO group the intensity of postoperative pain was 3.3 ± 0.5. Transient paresthesias were registered in 3 (5.5%) cases, local ecchymoses were in 21 (38.2%) cases. One patient (1.8%) had a complication looking like a burn. Thromboinduced thrombophebitis in 4 (7.3%) patients was regarded as a post EVLO complication caused by slow obliteration in some vein segments. Conclusion. High effectiveness of RFO and EVLO techniques has been confirmed in the present study. Though both techniques for endovasal obliteration have similar effectiveness, RFO seems to be less aggressive because of less pain syndrome, less bleeding and hematomas, what improves healing processes. Longer and larger observations could provide better and more accurate comparison of these two endovasal obliteration techniques.

Purpose: in the last decade, interstitial or intracavital laser surgery has been applied in such pathologies as hygroma, osteoarthritis, joint instability. Adverse events of interstitial laser surgery in orthopedics are not much discussed in literature. The aim of the present study was to assess character, occurrence and severity of adverse events in patients who underwent interstitial laser obliteration for Baker cysts. Materials and methods: patients with Baker cysts were taken into the study. All patients with synovial cavital formations in the popliteal region had sonographic examination. Then under the sonographic control a cyst was punctured with a needle through which a sterile quartz optic laser fiber was inserted. Formation of hyperechoic shadows which filled the entire cyst cavity indicated the end of the treatment session. Clinical effectiveness of the studied technique was evaluated analyzing the dynamics of some clinical symptoms and using a score scale. Results: In 2-3 days after laser obliteration the researchers could mostly observe local manifestations looking like local swelling and ecchymoses and having a moderate form of severity. Pain syndrome was mild; no pareses and paresthesias. In 7-10 days after the exposure local and pain symptoms became similar by occurrence and markedness; they had completely regressed in one month. Neurological and serious adverse events were not registered.

Purpose. To assess morphological, vascular, culture and immunohistochemical changes in the endometrium in women with chronic endometritis without exacerbation before and after the combined treatment in which a matrix red pulsed laser light with wavelength 635 nm was used. Materials and methods. 120 women were enrolled in the study. Their treatment included irradiation with low-level pulsed red laser light generated by laser device «Matrix» (wavelength 635 nm, pulse power 40 W, exposure 100-130 nsec). An original laser therapeutic technique was used for the treatment. 20 patients who had no laser therapy were controls. Histological and immunohistochemical tests in which lysozyme, CD68 macrophages, CD31 endothelial cell markers, CD56 + , CD16 + killer cells, and the activation marker of class II HLA-DR + were defined, were used by the researchers for endometritis diagnostics. For assessing the severity of chronic endometritis process a quantitative technique was used. Culture examination and polymerase chain reaction (PCR) helped to investigate endometrial microflora. Results. Matrix-assisted pulsed red laser (635 nm) has anti-inflammatory, immunomodulatory and vasoactive effects which can be successfully used for treating chronic endometritis. Conclusion. The studied type of laser is the most effective tool for the treatment for chronic endometritis.

The authors discuss their experience in treatment of 517 patients with complicated forms of cholelithiasis using modern medical laser technology. The main group (204 patients) included patients who developed treatment algorithm used, implies the use in different stages of treatment laser radiation of varying intensity. The use of laser irradiation reduced the number of complications, reduce the time of hospital stay and reduce postoperative mortality.

The aim of our study was to background the effectiveness and safety of Ho:YAG laser lithotripter for treating large and corallike kidney stones of high density refractive to ultrasound lithotripters. The obtained results demonstrate that laser (Ho:YAG) lithotripsy is an effective technique for the contact fragmentation of large and coral-like kidney stones of high density. Such type of lithotripsy is more effective than pneumatic fragmentation because of less rate of complications and better stone free rate.

Low-level laser light was used in 40 patients with chronic scarring stenosis in the larynx and trachea of various location and etiology. All patients were in the ENT department of the clinical hospital of Moscow region (MONIKI). 10 of these patients had laser therapy before surgical intervention (group 1); 10 patients had laser therapy before and after surgical intervention (group 2); 10 patients had laser therapy only after surgical intervention (group 3); 10 patients (control group) had no any laser therapy. The best results were seen in group 2. The variation coefficient was increased by 2 folds according to laser Doppler flowmetry findings.

Purpose. To study pathological changes in the ischemized spinal cord of rats so as to define a possibility to use laser light of the near infrared spectrum for the correction of structural and functional disorders in spinal stroke in the experiment. Histological, morphometric and statistical methods were used in the study. Results. The findings obtained after a quantitative morphological examination of spinal cord preparations have showed that the number of normal neurons and blood vessels was significantly larger and the number of neurons with chromatolysis and shadow-cells was less as to compared with the 1 series of comparison group under near infrared laser light irradiation.

For the last two decades a scientifically-grounded direction on photodynamic therapy (PDT) application in oncology and in several other medical spheres has been developed. If to compare with traditional techniques for treating cancer, PDT has a number of indisputable advantages. Moreover, PDT has also some advantages in treating chronic purulent infection (unhealing wounds, trophic ulcers of vascular etiology, etc.). In 2002 for the first time PDT was included into standard registers for treating malignant neoplasms, and since 2013 PDT has officially been regarded as one of possible alternative techniques for malignant neoplasms in the majority of locations. To finally accept PDT as a new medical technology with a perspective of wide practical application a socio-economic assessment of this technique effectiveness is required. On analyzing Russian and foreign publications with computerized models «price-effectiveness», expert conclusions and own experience, the authors came to the conclusion that PDT costs 3 folds less than surgical treatment of similar patients; it is 2 times less expensive than laser photodestruction and multicourse polychemiotherapy. Besides, PDT, in average, prolongs life of patients with an extensive tumoural process for 129 days more as compared to intensive surgical treatment and for 48 days more as compared to chemiotherapy. In patients with an extensive tumoural process and esophageal obturation palliative PDT is objectively more effective and safe as compared to YAG-ND recanalisation.

The increase of antibiotic resistance in microorganisms, leading to negative results of treatment of patients with purulent-inflammatory diseases of various localization, is one of the leading health problems. Development of new antibiotics is a long and complicated process. So, recently, there have appeared much information in medical literature on potentials to develop new untraditional techniques for antimicrobial therapy, one of which is the antimicrobial photodynamic (APD) therapy. It has been found out that long-lasting inflammatory processes, which are difficult to treat traditionally, are caused by the film formation process. The latest and the most effective way to destroy the above-mentioned films in the combination of Acetylcysteine and APDT therapy.

Seborrheic keratosis and actinic keratosis of the skin are precancerous lesions on the skin. It means that they have to be treated. Currently, there are many techniques for this (chemical, pharmacoimmunological, physical, combined). The given review presents various curative approaches to treat this pathology, as well as it discusses their effectiveness and drawbacks.

Treatment of purulent scrotum wounds is still complicated and not finally solved problem yet. In the majority of cases the primary surgical treatment of purulent focus is an indisputable approach; however, further curative tactics remains to be a field for discussions. High antibiotic resistance necessitates searching additional methods for postoperative therapy. One of such methods is photodynamic therapy (PDT) which is a modern technique actively developing world-wide for treating different oncologic and non-oncologic diseases. PDT effectiveness does not depend on pathogenic microorganism sensitivity. Given the ability of photosensitizes to accumulate predominately in cells prone to high proliferative activity, topical PDT application promots topical photocytotoxic effect at the bacterial microflora in wounds. Consequently, it allows to improve curative effectiveness and to have stable and reproducible results.