LASERS IN MEDICINE

    Instead of introduction: "Laser medicine" - the term which has made a lot of noise.
    Our country is the native land of the lasers. But Russia is one of the first countries, as well, who has seen also the prospect of their application in medicine and is one of the first 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, and then of small private enterprises has successfully mastered a manufacture of therapeutic and surgical laser devices, selling their thousand in domestic market and abroad. Surgical, and especially therapeutic applications of lasers today in our country are so wide that many experts seriously speak about the lead 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 researches. 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 functional conditions of tissues and organs of patients at carrying out of any procedures of NMS, and also any treatment-and-prophylactic procedures on a basis of LLLR, photodynamic therapy (PDT), etc. also enters into a circle of our interests. Today these works are spent together with scientific group of the Oryol State Technical University. The special attention is given to studying of changes of parameters of blood microcirculation and tissues' breath, as most sensitive to LLLR (according to literature) and most reliably registered by NMS methods (reflectance tissues oximetry, laser Doppler flowmetry, etc.). However till today we cannot fix any changes in a blood microcirculation system at LLLT without heating...

     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 like "MONIKI". In the institute, almost all sections of medicine (except for 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's point of view: interpretation of results of fluorescent diagnostics in a wide spectral range of wavelengths for identification of accumulation of endogenous fluorophores in tissues (NADH, collagen, FAD, etc.) and studying by NMS methods of features of reaction of blood microcirculation under any functional loading tests as well as under treatment-and-prophylactic procedures, physiotherapy procedures, for example, including medicinal tests.   

     Development of new diagnostic equipment for medicine.
     One of directions of scientific researches 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 researches (MONIKI) acts in a role of a medical coauthor of developments which defines the basic medical-technical requirements (MTR) to the device, its basic functionality, a principle of action, a technique of processing and analysis of diagnostic results, an application technique 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.