LASERS IN MEDICINE
Instead of introduction: "Laser medicine" - the term which has made a lot of noise.
Our country is the native land of lasers. Moreover, Russia is one of the first countries who has seen also the prospect of their application in medicine and is one of the first countries who initiated a wide spectrum of scientific researches in this direction. Thanks to Russia, lasers were involved into medicine practically from the moment of their birth, having generated the whole new direction in medicine with the well-known today total name «Laser Medicine». A number of state plants, and then of small private enterprises have successfully mastered in 1990-th a manufacture of therapeutic and surgical laser devices, selling thousands of them in the domestic market and abroad. In 1990-2015, surgical and especially therapeutic applications of lasers in our country were so wide that many experts seriously talked about the leading position in the world of Russia in the field of laser medicine. Especially in the area of Low-Level Laser Therapy (LLLT). Meanwhile, low-level laser technologies in medicine not all are indisputable, and aren't limited only to frameworks of carrying out of medical procedures. There is still a big field for scientific research. As not less perspective area of their application in medicine, for example, it can be considered the so-called noninvasive (nondestructive, in vivo, in situ) diagnostics.
Contemporary stage of the "laser" research in the laboratory.
For us the term "laser medicine" first of all means the laser medical diagnostics. Keeping continuity and the saved up scientific reserve in the field of laser methods of diagnostics in medicine, biophotometry, biomedical spectroscopy, etc. (see section "About laboratory", subsection "History") our laboratory continues today researches in the field of optical noninvasive diagnostics. Earlier, in 2002-2008, we managed to isolate and formulate the basic object of research in biophotometry, to show likeness of problems of biophotometry to usual problems of a conventional clinical laboratory spectrophotometry with distinction only in lifetime and noninvasive character of measurements and to predict occurrence of the multifunctional diagnostic systems realizing on the uniform equipment various methods of optical noninvasive diagnostics (see Rogatkin D.A., Lapaeva L.G. // Biomed. Engineering, Vol. 37, No. 4, 2003. - p.217-222). Therefore, since 2003 this scientific direction has received the new generalizing name "Noninvasive medical spectrophotometry" (NMS), and today researches on NMS are spent on following basic sections:
Scientific and engineering theory of modeling, projecting and creation of hardware, software and methodical ware for noninvasive medical spectrophotometry (NMS) in addition to our researches executed earlier is developing by us today in the direction of creation of scientifically well-founded system of metrological maintenance for NMS. Both for methods, and devices. Physical, medical and biologic sources of random and regular errors in NMS (both instrumental, and methodical) are investigated. Imitating optical measures are developed for calibration, adjustment and checking of devices of NMS. Reached levels of errors for different methods and devices in a laboratory and in conditions of natural applications of the devices and techniques in various clinics of institute and various areas of medicine are estimated. On this basis in 2013 it was shown, for example, that in the design of Russian laser Doppler flowmeters of the LAKK series there are systemic errors that often lead to distortion and incorrect registration of the microcirculation rhythms. Later, in 2016-2017, we managed to find gaps in the theory of laser Doppler flowmetry (LDF) and showed that it is possible to register the same parameters of microcirculation without the use of lasers and the Doppler effect ...
Physical and technical aspects of influence of low-level laser radiation (LLLR) on the functional condition of the blood microcirculation system at carrying out of any treatment and(or) prophylactic LLLR-based procedures, low-level laser therapy (LLLT), for example, photodynamic therapy (PDT), etc. This problem also enters into a circle of our interests. The special attention in 2009-2013 was given to studying of changes of parameters of blood microcirculation, as the most sensitive to LLLR (according to literature) and the most reliably registered effect by NMS methods (reflectance tissues oximetry, laser Doppler flowmetry, etc.). However, till today we cannot fix any changes in a blood microcirculation at LLLT without heating...Read more ...
Clinical methods and interpretation of results of the laser diagnostics is the most interesting and profile chapter of our research, especially for such big and multiprofile medical research center as "MONIKI". In the institute, almost all sections of medicine, excepting psychiatry and gynecology, are presented. So, there are excellent possibilities to study an efficiency and informativeness of laser diagnostic methods for solution of different applied problems of the practical public health services (differential diagnostics and revealing of early forms of diseases, monitoring of process of treatment, functional diagnostics and so on). Among all these problems for NMS, two problems are the most difficult and perspective from the fundamental science point of view: interpretation of results of fluorescent diagnostics in a wide spectral range of wavelengths for evaluation of quantitative accumulation of endogenous fluorophores in tissues (NADH, collagen, FAD, etc.) and the study by NMS methods of features of blood microcirculation system (BMCS), of its functioning in both normal and pathological conditions, as well as the study of reactions of BMCS to various functional load tests and therapeutic treatment- and(or) prophylactic procedures, physiotherapy procedures, for example, including medicinal tests. Recently, in connection with the development of the comprehensive non-invasive diagnostic technology "Vasotest", in addition to the parameters of microhemodynamics, it has become possible to study other parameters of central and peripheral hemodynamics in normal and pathological conditions - the speed of propagation of a pulse wave in the aorta and peripheral arteries, vascular tone of the arterial bed and others.Read more ...
Development of new diagnostic equipment for medicine.
One of directions of scientific research in our laboratory all these years was the development of new diagnostic tools for NMS under contracts on scientific and technical cooperation with firms-manufacturers of medical equipment. In these contracts the laboratory of medical and physics research (MONIKI) acts in the role of medical co-author of developments which defines the basic medical-technical requirements (MTR) to the device, to its basic functionality, principles of action, a technique of processing and analysis of diagnostic results, application methods in medicine, etc. In this field with laboratory participation such known Russian devices as the first Russian portable reflectance tissues oximeter "Spectrotest" and a multipurpose laser noninvasive diagnostic system (MLNDS) "LAKK-M" have been developed, created and put to the medical equipment market. Starting from 2018, a tonometer-baser device is being prepared for production and registration for the implementation of the new comprehensive diagnostic technology "Vazotest" for assessing a large set of parameters of central and peripheral hemodynamics.