[Biospectroscopy-based endoscopy with low-intensive laser radiation for differential diagnostics and treatment of peptic ulcer].

The article covers results of application of biospectrometry-based endoscopy with low-intensive He-Ne laser radiation in complex therapy of torpid esophageal, gastric, and duodenal ulcers. The authors are the first to offer a method based upon individual biophotometric control (autofluorescence, oxigination), which allows verification of the ulcerous process character, individual optimization of treatment and objective control of ulcer regression.

[Registration of surface fluorescence of endogenous porphyrins during low-level laser therapy of gastric and duodenal ulcers]. / Izmerenie poverkhnostei fluorestsentsii éndogennykh porfirinov v protsesse lazeroterapii iazv zheludka i dvenadtsetiperstnoi kishki.

With the use of the developed opto-fiber spectroscope and gastroscope, the intensity of fluorescence from the ulcer surface into the gastrointestinal tract was measured in the range of 670-690 nm under the He-Ne laser (= 632.8 nm) illumination. Surface fluorescence data were collected with the use of a special diagnostic fiber with a total diameter of about 2 mm, which combines some illuminating and receiving fibers. To do the measurements, the diagnostic fiber was brought into a slight contact with the mucosa surface. The quantitative results were calculated with the use of the special fluorescent contrast coefficient (Kf), which takes into account the backscattered light as well. After the fluorescent diagnostic procedure, the low-level laser therapy was applied to all patients. It was found that: first of all, during the laser medical cure the registered fluorescence for the patients with a good dynamics of treatment had an evident tendency to a decrease, and the coefficient Kf for observed ulcers tended to approach the value obtained from normal mucosa (Kf), which indicates the normalization of the porphyrin content in the tissue. Second, the retrospective analysis of the efficacy of laser therapy versus initial values of Kf showed that, for the patients with the initial values Kf = 0.2, the efficiency of the laser treatment was the highest: the relation between the patients with good treatment results and bad ones was 4:1 (more than 80%). For the initial Kf = 0.2-0.3, this relation was 3:1 but for Kf = 0.4-0.5 it was 2:3. The differences in the efficiency of the low-level laser therapy, except the cases of the cancer in the ulcers, may be due to different content of porphyrin in the tissue: at high concentrations of the photosensitizer in the ulcer, the effect of the overdosing could be realized. In this case, another technology of laser illumination is needed. The results are discussed in terms of the free-radical conception of the stimulating effect of laser radiation.