We presented the preliminary results of sentinel lymph node biopsy (SLN) using the method of fluorescent visualization with the indocyanine green. The study included 40 breast cancer patients with the prevalence of the cTis-2N0M0 process. 1 ml of Indocyanine Green (ICG) aqueous solution was administered periareolarly and subcutaneously from the tumor side with total drug dose of 5 mg. In the following few minutes the ICG trail along the lymphatic vessels was observed by its fluorescence in the infrared spectral range using a special camera with image transmitted to a computer screen. After the trail reached the axillary region and broke off, skin and subcutaneous tissue incision in axillary area was made, and the superficial fascia was dissected. The first contrasted lymph nodes were extracted. The incidence of SLN was 92.5%. Metastases were detected in 20% of cases. On average, it took 17.6 minutes to identify and remove the SLN. In 7 patients the use of the fluorescent SLN detection method was combined with radioisotope (Technefite ^99m Tc colloid) – in all cases the same SLN was identified. The use of the ICG lymphotropic dye with the subsequent detection of SLN by the fluorescence method makes it possible to diagnose the status of SLN with a high degree of accuracy and can be comparable in effectiveness with the isotopic method. The specificities of lymphatic drainage were found out with the use of fluorescence lymphography: inverse dependence of the lymphatic drainage rate on the body mass index and breast size, and absence of dependence on degree of ptosis of breast.

Mechanical and drug treatment of the root canal are the most important components of the success of endodontic treatment. This work presents the results on the effectiveness of the root canal disinfection using an erbium laser in combination with a 17% solution of ethylene diaminetetraacetic acid (EDTA) in vitro and in clinical studies. An in vitro study was carried out on removed intact teeth infected with strains of Enterococcus faecalis, Streptococcus sanguinis, and Candida albicans. An experimental group of teeth was treated medically according to a standard protocol using 3% solution of sodium hypochlorite and 17% solution of EDTA followed by irradiation with erbium laser. The control group was treated similarly but without laser irradiation. The treatment effectiveness was evaluated by the reduction of CFU. After the treatment, in the control group after the mechanical and drug treatment, the CFU amount lowered by 4 times, while the complete sterilization was observed in the experimental group. The clinical studies included two groups of 35 patients each diagnosed with chronic periodontitis. In the experimental group of patients, at the final stage, treatment with erbium laser for 1 min using endodontic piece (40 mJ power, 2940 nm wavelength, 10 Hz pulse rate) and a 17% EDTA solution was performed before filling. Periodontitis treatment in the control group was carried out without the laser treatment. The control group of patients saw the reduction on CFU after the mechanical and drug treatment by 3–6 times, while the experimental group achieved the complete sterilization of the root canals. The obtained results prove that the modification of the root canal treatment by the inclusion of erbium laser irradiation is a promising direction in endodontics.

It is essential in interstitial Photodynamic therapy (iPDT) treatment planning to ensure a homogeneous distribution within a tumor volume using cylindrical diffusing fibers while keeping the surrounding tissue intact. Light distribution is simulated through two algorithms based on the diffusion equation assuming diffusers as light sources. The first algorithm analyzes the diffusion equation and studies the effects of different variables (optical properties, delivered power, diffuser length, and position). Next, optical properties of breast were applied to estimate the volume that receives accepted light dose from one diffuser. In the second algorithm, multiple diffusers were simulated in order to find the relation between the volume and the number of required diffusers which are needed to cover cubical or cylindrical volume with sufficient light dose. Throughout this study, real values of optical properties, clinical laser power, and treatment time were considered to evaluate sufficient light doses. This study is in agreement with previous works in that optical properties are the major factors influencing light distribution in iPDT. It is shown that for a homogeneous phantom mimicking breast cancer and cubical or cylindrical shape, the number of required fibers N equal W×L or D² respectively.

This work is a review of modern scientific data on the process of aging, as well as the prospect of using photodynamic therapy for correction of involutional skin changes in the age cohorts, cohorts with a burdened medical history, including cancerous and precancerous skin neoplasms. The data on the predicted increase in life expectancy and, as a consequence, the potential risk of pathologies, including those with skin localization, progression of malignancy processes, as well as the formation of de novo elements, is presented. The increase in life expectancy also demonstrates the socialization of the elderly population, along with the increasing need for correction of involutional skin changes. However, considering the risks associated with the chronic diseases and increased malignancy in this cohort, methods have to be carefully selected. One such technique is photodynamic therapy (PDT). PDT is actively used in oncology, and recently has been increasingly showing its aesthetic effectiveness. It can be predictably used not only on cancer patients, but also in an age cohort.

The article presents a methodology and results of developing diagnosis related groups (DRGs) for the cases of healthcare provided with the use of radiotherapy and chemoradiotherapy for malignant neoplasms in Russian Federation. A key element of the methodology is the standardized module of healthcare (SM) which allows calculating the tariffs for medical care in accordance with clinical guidelines. As a result of the application of the new methodology, in 2019, changes were made to the DRG model in terms of payment for radiotherapy and chemoradiotherapy. The changes included developing 10 DRGs for in-patient radiotherapy and 10 DRGs in day hospital; 7 DRGs for in-patient chemoradiotherapy and 5 DRGs in day hospital. New classification criteria have been introduced into the DRG model for attributing the case to a certain DRG, in addition to the medical service used before. The number of fractions became a new criterion for radiotherapy, the number of fractions and the international non-proprietary name of the drug were proposed for chemoradiotherapy. A wider range of DRG’s weight coefficients was calculated, which allows more differentiated reimbursement of the costs of medical care provided by medical organizations depending on the method and the regimen used.

The results of an 11-year clinical observation and treatment of a patient with stage II basal cell carcinoma of the face (Т2N0M0) are presented. History of the illness is associated with a long (from 2001 to 2008) inadequate treatment, due to the incorrect diagnosis. After the proper diagnosis was established, from 2008 to 2019 at the Center for Laser and Photodynamic Diagnostics and Tumor Therapy of P.A. Herzen Moscow Oncology Research Center, the patient underwent organ-preserving treatment using the multi-course photodynamic therapy (PDT) and drug targeted therapy. In total, 23 courses of PDT were conducted with photosensitizers of the chlorin series and 5-aminolevulinic acid during this period. Since 2018, the patient is in the process of targeted drug treatment with Vismodegib. In the course of targeted drug treatment, a follow-up examination in 2019 revealed continued growth of the residual tumor, and another course of PDT was carried out. Throughout the observation period, the patient tolerated the treatment well, without complications, with a good quality of life and satisfactory cosmetic effect.