Interstitial photodynamic therapy (iPDT) is a minimally invasive treatment method based on the interaction of light, a photosensitizer (PS) and oxygen. In brain gliomas, iPDT involves the stereotactic introduction of one or more light guides into the target area to irradiate tumor cells and tissues that have accumulated PS, which subsequently causes necrosis and/or apoptosis of tumor cells, destruction of the tumor vascular network and causes an inflammatory reaction that triggers stimulation of the antitumor immune response.

 The aim of the study was to analyze the possibility of using iPDT in the treatment of unifocal, small-sized (up to 3.5 cm) glioblastomas.

 The study with iPDT included 7 patients with a unifocal variant of glioblastoma with a maximum tumor size of up to 3.5 cm and a Karnofsky score of at least 70 points. In 5 patients (71.4%) there was a relapse of glioblastoma, in 2 cases (28.6%) the tumor was diagnosed for the first time. As a PS, PS photoditazine was used, administered intravenously by drip at a dose of 1 mg/kg. Interstitial irradiation was performed using a laser (Latus 2.5 (Atkus, Russia)) with a wavelength of 662 nm and a maximum power of 2.5 W and cylindrical scattering fibers. The target tumor volume was determined after combining multimodal CT images (contrast-enhanced scanning, axial slices of 0.6 mm) with preoperative MRI, PET. Spatial precise interstitial irradiation of the tumor volume was planned using special software. The duration of irradiation did not exceed 15 min. The light dose was from 150 to 200 J/cm2. Transient clinical deterioration was recorded in about 2 patients (28.6%). These 2 patients had worsening neurological deficits in the early postoperative period (increase in hemiparesis from 4 points to 2 points in one patient and development of dysarthria and dysphasia in the second patient). The median overall survival from the first diagnosis of malignant glioma to death was 28.3 months. The median relapse-free survival was 13.1 months. MGMT status played a significant role in the outcome of patients treated with iPDT. Patients with a methylated MGMT promoter survived longer than patients with an unmethylated MGMT promoter by a median of 22.1 months, and they did not experience disease progression for an additional 9.3 months.

 iPDT may be a promising treatment option in a population of patients at high risk of postoperative neurological deficit. It does not interfere with, but rather may complement, other treatment options for this disease, such as repeat radiation therapy and chemotherapy. iPDT remains a potential option for deep-seated gliomas in patients with high surgical risk and in case of tumor recurrence.

A new method has been proposed for the treatment of gunshot wounds complicated by nosocomial microflora. The method is based on the treatment of wounds with high-intensity pulsed optical radiation of a continuous spectrum in the wavelength range from 200 to 1100 nm. A pulsed xenon lamp is used as a radiation source.  The effect of high-intensity pulsed wide-spectrum optical radiation and low-intensity continuous UV radiation with a maximum at a wavelength of 272 nm and a half-width of the spectrum of 12 nm on the course of the wound process in a gunshot injury was compared. It has been shown that the effect of such radiation on tissues with signs of purulent-inflammatory process provides an antibacterial effect and stimulates tissue regeneration. At the same time, high-intensity wide-spectral optical radiation has a more pronounced anti-inflammatory effect and contributes to the earlier development of tissue regeneration compared with low-intensity narrow-spectrum UV radiation. However, the use of high-intensity optical radiation requires an individual dosage for each phase of the wound process.

An experimental model of an infected wound was created in 90 Wistar rats using a mixture of cultures of Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Candida albicans. The animals are divided into 3 groups of 30 individuals. The first group consisted of animals treated with pulsed high-intensity broadband irradiation using an experimental apparatus with a pulsed xenon lamp operating in a pulsed periodic mode with an average UV-C (200-280 nm) radiation power of 3 W, and a pulsed UV-C power of 24 kW. In the second group, traditional ultraviolet irradiation of wounds with a mercury bactericidal lamp was used for treatment, with an average UV-C (254 nm) radiation power of 1.2 W. The third group received only a local antiseptic treatment. The computer planimetry was used for monitoring the effectiveness of treatment. Parameters such as wound area, rate, and degree of epithelialization were recorded on days 1, 7, 14, and 21 of treatment. The study showed that in the first group of animals, the rate and degree of epithelialization, as well as the reduction in wound area at each control stage, were statistically significantly greater compared to the use of traditional ultraviolet irradiation and local antiseptic monotherapy. This dynamic is associated with the earlier cleansing of wounds from pathogenic microorganisms and the morphological changes that correspond to an earlier transition from the inflammatory phase to the proliferation and regeneration phases. Therefore, the local treatment of infected wounds with antiseptic agents in combination with pulsed high-intensity wideband radiation promotes the earlier epithelialization of the wounds.

This article discusses the processes of 5-aminolevulinic acid (5-ALA) metabolism, as well as the accumulation and photobleaching of protoporphyrin IX (PpIX) during photodynamic therapy (PDT) of benign skin tumors using the application method of introducing a 20% 5-ALA solution. The exposure time of the drug was 4 h. The study included two patients, one with dermatofibroma and one with congenital melanocytic nevus. Spectral fluorescence study was performed by fluorescence excitation using lasers at wavelengths of 405 and 632.8 nm. Fluorescence of normal and pathological tissues was recorded in the range of 350-800 nm at λ_exc =405 nm and in the range of 600-750 nm at λ_exc =632.8 nm. The dynamics of PpIX accumulation was studied. In the superficial tissue layers (at λ_exc =405 nm), the maximum accumulation of PpIX was recorded 3 h after the 5-ALA administration. In deeper tissue layers (at λ_exc =632.8 nm), the PpIX accumulation increased during 4 h of observation. After PDT with laser radiation with a wavelength of 635 nm, photobleaching of PpIX and the formation of its chlorin-type photoproducts with a fluorescence maximum in the range of 670–700 nm were observed. It was not possible to establish the presence of uroporphyrins I and III and/or coproporphyrin I, which could indicate a disturbance in the mitochondrial metabolism of necrotic cells. The obtained results expand the possibilities of spectral-fluorescent diagnostics and can contribute to increasing the effectiveness of 5-ALA-PDT of tumors.

Hyperparathyroidism (primary, secondary and tertiary) is a common endocrine disease, often occurring with pronounced symptoms, in most cases caused by adenoma (rarely several adenomas) in primary hyperparathyroidism (pHPT) and chronic renal failure in patients on programmed hemodialysis with secondary (sHPT) and tertiary (tHPT) hyperparathyroidism. To date, the only radical treatment for hyperparathyroidism (HPT) is surgical removal of pathologically altered parathyroid glands. In this regard, there is a need to improve diagnostic search algorithms, including intraoperative ones, for altered parathyroid glands. The main objective of the review is to study current trends and techniques of intraoperative imaging of the parathyroid glands, compare these methods and evaluate their effectiveness. The use of qualitatively new technologies for the topical diagnosis of altered parathyroid glands, such as identification by autofluorescence in the near infrared spectrum (NIRAF), the technique of using indocyanine green (ICG) and 5-aminolevulinic acid under UV radiation, make it possible to visualize the localization of the parathyroid glands with more than 90% accuracy. However, the issue of their priority use remains open and unresolved.